Organization
MEMORIAL HOME CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG CONRAD (VP & GENERAL MGR)
15746478777
Entity
Organization
Contact information
Practice address
3355 DOUGLAS RD, SOUTH BEND, IN 46635-1781
(574) 273-2273
Mailing address
3355 DOUGLAS RD, SOUTH BEND, IN 46635-1781
(574) 273-2273
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
10-012264-1
IN
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
69000137A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100263690
—
IN
05
—
100301140A
—
IN
Enumeration date
02/06/2008
Last updated
09/20/2010
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