=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710444567
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMMUNITY HEALTH AT HOME - INFUSION, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2019
-----------------------------------------------------
Last Update Date | 05/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8034 CASTLEWAY CT W STE 200
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46250-1915
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-621-4800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6281 TRI RIDGE BLVD STE 300
-----------------------------------------------------
City | LOVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45140-8345
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-576-0262
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | V.P. FINANCE & CFO
-----------------------------------------------------
Name | JACK HAWKINS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 513-576-8478
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336H0001X
-----------------------------------------------------
Taxonomy Name | Home Infusion Therapy Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251F00000X
-----------------------------------------------------
Taxonomy Name | Home Infusion Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------