Organization
FAIRMEADOWS HOME HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE S KUCKA R.PH. (PRESIDENT)
(219) 865-5960
Entity
Organization
Contact information
Practice address
1325 E MAIN ST, GRIFFITH, IN 46319-2932
(219) 865-5960
(219) 865-5966
Mailing address
PO BOX 789, SCHERERVILLE, IN 46375-0789
(219) 865-5960
(219) 865-5966
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097364
ANTHEM
IN
05
—
100299080
—
IN
Enumeration date
05/24/2005
Last updated
03/17/2018
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