Healthcare Provider Details

I. General information

NPI: 1881993806
Provider Name (Legal Business Name): AUBURN HOME MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 03/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 E 7TH ST
AUBURN IN
46706-2535
US

IV. Provider business mailing address

1314 E SEVENTH ST.
AUBURN IN
46706
US

V. Phone/Fax

Practice location:
  • Phone: 260-927-8052
  • Fax: 260-927-8086
Mailing address:
  • Phone: 260-927-8052
  • Fax: 260-927-8086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: SCOTT A BOOKER
Title or Position: CEO
Credential:
Phone: 260-927-8052