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General NPI Number Information
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NPI Number | 1982753588
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Entity Type | Organization
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Legal Business Name | TENDERCARE HOME HLTH SVC - DME
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6308 RUCKER RD STE D
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-4881
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Country | US
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Telephone | 317-251-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 6308 RUCKER RD STE D
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-4881
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Country | US
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Telephone | 317-251-0700
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LESLIE DEITCHMAN
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Credential | RN
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Telephone | 317-251-0700
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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 | 69-000159-A
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License Number State | IN
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