Organization
HOME HEALTH DEPOT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID A. HARTLEY JR. (PRESIDENT)
(317) 333-6033
Entity
Organization
Contact information
Practice address
7040 GUION RD, INDIANAPOLIS, IN 46268-4812
(317) 333-6033
(317) 333-6034
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
69000543A
IN
332B00000X
Durable Medical Equipment & Medical Supplies
HMER 22686
OH
332BC3200X
Customized Equipment (DME)
Primary
69000543A
IN
332BC3200X
Customized Equipment (DME)
HMER 22686
OH
332BX2000X
Oxygen Equipment & Supplies (DME)
600262
MN
332BX2000X
Oxygen Equipment & Supplies (DME)
69000543A
IN
332BX2000X
Oxygen Equipment & Supplies (DME)
831955559
IN
332BX2000X
Oxygen Equipment & Supplies (DME)
HMER 22686
OH
332BX2000X
Oxygen Equipment & Supplies (DME)
MG0784
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097481
ANTHEM BC/BS
IN
05
—
200206500A
—
IN
05
—
200951220A
—
IN
Enumeration date
12/07/2006
Last updated
02/10/2012
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