Organization
MAIN STREET HOSPICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS KEITH WEDDLE (CFO)
(317) 736-0055
Entity
Organization
Contact information
Practice address
10 HIGHLAND AVE, FRANKLIN, IN 46131-1230
(317) 736-0055
(317) 739-3505
Mailing address
10 HIGHLAND AVE, FRANKLIN, IN 46131-1230
(317) 736-0055
(317) 739-3505
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
251G00000X
Community Based Hospice Care Agency
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
06/01/2021
Last updated
09/03/2021
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