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General NPI Number Information
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NPI Number | 1982176996
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Entity Type | Organization
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Legal Business Name | AT HOME MEDICAL SUPPLY
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 01/02/2019
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Provider Practice Location Address
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Address Line | 4040 W 71ST ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-5722
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Country | US
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Telephone | 888-678-4160
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Fax | 866-365-4846
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Provider Business Mailing Address
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Address Line | 4040 W 71ST ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-5722
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Country | US
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Telephone | 888-678-4160
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Fax | 866-365-4846
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. LEATRICE RILEY
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Credential |
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Telephone | 888-678-4160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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