MEDICARE: TENDERCARE HOME HLTH SVC - DME

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	332B00000X	Durable Medical Equipment & Medical Supplies	69-000159-A	IN

General Provider Information

NPI Number	:	1982753588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENDERCARE HOME HLTH SVC - DME

Provider Business Mailing Address
First Line	:	6308 RUCKER RD STE D
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4881
Country	:	US
Telephone Number	:	317-251-0700
Fax Number	:

Provider Business Practice Location Address
First Line	:	6308 RUCKER RD STE D
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4881
Country	:	US
Telephone Number	:	317-251-0700
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LESLIE DEITCHMAN
Credential	:	RN
Telephone Number	:	317-251-0700

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	08/22/2020

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