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General NPI Number Information
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NPI Number | 1578205548
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Entity Type | Organization
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Legal Business Name | INDIANA HOME BASED PRIMARY CARE PC
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 11595 N MERIDIAN ST STE 515
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City | CARMEL
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State | IN
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Zip | 46032-6969
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Country | US
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Telephone | 800-807-6555
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Fax | 855-316-2999
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Provider Business Mailing Address
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Address Line | 805 N WHITTINGTON PKWY STE 400
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City | LOUISVILLE
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State | KY
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Zip | 40222-7102
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Country | US
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Telephone | 502-394-2100
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM ROBERT MILLS
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Credential | MD
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Telephone | 502-394-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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