MEDICARE: 1ST PURPOSE CARE 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

General Provider Information

NPI Number	:	1639911886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1ST PURPOSE CARE LLC

Provider Business Mailing Address
First Line	:	2624 GREYFRIAR CT APT 1B
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-1449
Country	:	US
Telephone Number	:	317-799-4438
Fax Number	:

Provider Business Practice Location Address
First Line	:	7640 HORSETAIL DR APT H
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-4597
Country	:	US
Telephone Number	:	317-799-4438
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TYANA CARPENTER
Credential	:
Telephone Number	:	317-799-4438

Provider Enumeration Date	:	06/10/2024
Last Update Date	:	06/10/2024

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Directions to “1ST PURPOSE CARE LLC ” Practice Location

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