Organization
HOMECARE ADVANTAGE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY MARTIN (PRESIDENT)
(812) 234-4602
Entity
Organization
Contact information
Practice address
185 E MCCALLISTER DR, TERRE HAUTE, IN 47802-4247
(812) 234-4602
(812) 234-4601
Mailing address
PO BOX 10241, TERRE HAUTE, IN 47801-0241
(812) 234-4602
(812) 234-4601
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
69000042A
IN
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
69000042A
IN
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
69000042A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200410140B
—
IN
Enumeration date
09/25/2006
Last updated
11/30/2010
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