Healthcare Provider Details

I. General information

NPI: 1346171659
Provider Name (Legal Business Name): PRIMELIFE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10594 WYATT DR
INDIANAPOLIS IN
46231-1035
US

IV. Provider business mailing address

10594 WYATT DR
INDIANAPOLIS IN
46231-1035
US

V. Phone/Fax

Practice location:
  • Phone: 502-855-0193
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DEV SUBEDI
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 502-356-9689