MEDICARE: CARETENDERS OF INDIANA, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	251B00000X	Case Management Agency
3	252Y00000X	Early Intervention Provider Agency
4	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000367931	OTHER	KY	ANTHEM PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114024320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARETENDERS OF INDIANA, INC.

Provider Business Mailing Address
First Line	:	9510 ORMSBY STATION RD
Second Line	:	SUITE 300
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-4081
Country	:	US
Telephone Number	:	502-891-1000
Fax Number	:	502-891-8067

Provider Business Practice Location Address
First Line	:	5000 BACK SQUARE DR
Second Line	:	BUILDING D
City	:	OWENSBORO
State	:	KY
Zip	:	42301-7411
Country	:	US
Telephone Number	:	270-685-3876
Fax Number	:	270-691-9405

Authorized Official
Title or Position	:	SR. V.P., ADMINISTRATION
Name	:	MR. PATRICK TODD LYLES
Credential	:
Telephone Number	:	502-891-1044

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/03/2008

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Directions to “CARETENDERS OF INDIANA, INC. ” Practice Location

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