MEDICARE: V&G HOME CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1013802909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	V&G HOME CARE, LLC

Provider Business Mailing Address
First Line	:	4034 N TACOMA AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-2921
Country	:	US
Telephone Number	:	317-832-0222
Fax Number	:

Provider Business Practice Location Address
First Line	:	4034 N TACOMA AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-2921
Country	:	US
Telephone Number	:	317-827-4058
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	TIFFANY R SPARKS
Credential	:
Telephone Number	:	317-827-4058

Provider Enumeration Date	:	06/11/2025
Last Update Date	:	06/12/2025

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