=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386453819
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DYNAMIC HOME CARE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2024
-----------------------------------------------------
Last Update Date | 12/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10475 CROSSPOINT BLVD STE 250
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46256-3387
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-618-5277
-----------------------------------------------------
Fax | 317-534-3913
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10475 CROSSPOINT BLVD STE 250
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46256-3387
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-618-5277
-----------------------------------------------------
Fax | 317-534-3913
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. ABDIRISAK J HASHI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-701-6668
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------