Organization
HOME HEALTH DEPOT
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
13 WESTPORT CT, UNIT B, BLOOMINGTON, IL 61704-3626
(309) 662-4000
(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
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
10/31/2010
Last updated
10/31/2010
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