Healthcare Provider Details

I. General information

NPI: 1992770028
Provider Name (Legal Business Name): GREENE COUNTY HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 08/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 A ST NE
LINTON IN
47441-1907
US

IV. Provider business mailing address

1185 N 1000 W
LINTON IN
47441-5282
US

V. Phone/Fax

Practice location:
  • Phone: 812-847-9496
  • Fax: 812-847-1825
Mailing address:
  • Phone: 812-847-9496
  • Fax: 812-847-1825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number005324
License Number StateIN

VIII. Authorized Official

Name: MRS. LEA ANN CAMP
Title or Position: PRESIDENT HHC BOARD
Credential: MSN, RN
Phone: 812-847-5213