Healthcare Provider Details

I. General information

NPI: 1932105830
Provider Name (Legal Business Name): INDIANA HOME HEALTH CARE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 W GIFFORD RD
BLOOMINGTON IN
47403-2612
US

IV. Provider business mailing address

3800 W GIFFORD RD
BLOOMINGTON IN
47403-2612
US

V. Phone/Fax

Practice location:
  • Phone: 812-334-1857
  • Fax: 812-330-4288
Mailing address:
  • Phone: 812-334-1857
  • Fax: 812-330-4288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateIN

VIII. Authorized Official

Name: MR. LEE J. MARCHANT
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 812-334-1857