Organization
HOME HEALTH DEPOT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI GOLDMAN (DIRECTOR OF CONTRACTING)
(317) 333-6033
Entity
Organization
Contact information
Practice address
2101 W CERMAK RD, BROADVIEW, IL 60155-4605
(708) 345-2466
(708) 345-2865
Mailing address
9245 N MERIDIAN ST, SUITE 200, INDIANAPOLIS, IN 46260-1836
(317) 333-6033
(317) 333-6034
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
203.001283
IL
332B00000X
Durable Medical Equipment & Medical Supplies
69000860A
IN
332BC3200X
Customized Equipment (DME)
Primary
203.000752
IL
332BC3200X
Customized Equipment (DME)
69000860A
IN
332BX2000X
Oxygen Equipment & Supplies (DME)
203.001283
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
69000860A
IN
Other
Enumeration date
10/31/2010
Last updated
06/30/2017
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