Organization
SPECIALIZED HOME CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACKIE O BODWELL (MEMBER)
(317) 538-3737
Entity
Organization
Contact information
Practice address
621 N CENTRAL AVE, CONNERSVILLE, IN 47331-2012
(317) 538-3737
Mailing address
621 N CENTRAL AVE, CONNERSVILLE, IN 47331-2012
(317) 538-3737
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
30005122A
IN
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
30005122A
IN
332BX2000X
Oxygen Equipment & Supplies (DME)
30005122A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201286800A
—
IN
Enumeration date
05/05/2014
Last updated
07/12/2015
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