MEDICARE: SENIOR CHECK-IN 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	253Z00000X	In Home Supportive Care Agency	17-612882-1	IN

General Provider Information

NPI Number	:	1427564384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR CHECK-IN LLC

Provider Business Mailing Address
First Line	:	14074 TRADE CENTER DR STE 147
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-4571
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14074 TRADE CENTER DR STE 147
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-4571
Country	:	US
Telephone Number	:	502-727-0085
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GRETCHEN MARIE ZOELLER
Credential	:
Telephone Number	:	502-727-0085

Provider Enumeration Date	:	12/14/2017
Last Update Date	:	12/14/2017

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Directions to “SENIOR CHECK-IN LLC ” Practice Location

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