Healthcare Provider Details

I. General information

NPI: 1114993490
Provider Name (Legal Business Name): COMMUNITY HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9894 E 121ST ST
FISHERS IN
46037-4154
US

IV. Provider business mailing address

9894 E 121ST ST
FISHERS IN
46037-4154
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-4800
  • Fax: 317-621-4811
Mailing address:
  • Phone: 317-621-4800
  • Fax: 317-621-4811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number60004988A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number69000274A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KEVIN STEWART
Title or Position: COO HME
Credential: RRT
Phone: 317-621-4810