MEDICARE: PATIENT FIRST HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1053186718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATIENT FIRST HOMECARE LLC

Provider Business Mailing Address
First Line	:	2109 E MICHIGAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-3160
Country	:	US
Telephone Number	:	317-982-1568
Fax Number	:

Provider Business Practice Location Address
First Line	:	2109 E MICHIGAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-3160
Country	:	US
Telephone Number	:	317-982-1568
Fax Number	:

Authorized Official
Title or Position	:	AGENCY MANAGER
Name	:	BREYANNA BOOKER
Credential	:
Telephone Number	:	317-982-1568

Provider Enumeration Date	:	11/22/2023
Last Update Date	:	11/22/2023

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