Healthcare Provider Details

I. General information

NPI: 1689630964
Provider Name (Legal Business Name): ABC HOME HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 09/11/2025
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 THATCHER AVE
PUEBLO CO
81005-1255
US

IV. Provider business mailing address

3715 THATCHER AVE
PUEBLO CO
81005-1255
US

V. Phone/Fax

Practice location:
  • Phone: 719-543-2700
  • Fax: 719-543-2704
Mailing address:
  • Phone: 195-432-7007
  • Fax: 719-543-2704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN-108761
License Number StateCO

VIII. Authorized Official

Name: MRS. TAMMY ANN WELDON
Title or Position: OWNER/LEAD CLINICAL NURSE
Credential: RN
Phone: 719-372-0444