MEDICARE: A-1 HEALTH & MEDICAL L.L.C.

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	10-012325-1	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10-012325-1	OTHER	IN	WAIVER

General Provider Information

NPI Number	:	1235458068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A-1 HEALTH & MEDICAL L.L.C.

Provider Business Mailing Address
First Line	:	7002 GRAHAM RD.
Second Line	:	SUITE #222
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4057
Country	:	US
Telephone Number	:	317-202-9400
Fax Number	:	317-252-8560

Provider Business Practice Location Address
First Line	:	7002 GRAHAM RD.
Second Line	:	SUITE #222
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4057
Country	:	US
Telephone Number	:	317-202-9400
Fax Number	:	317-202-9400

Authorized Official
Title or Position	:	CFO
Name	:	MS. CHERYL WILLISE FIELDS
Credential	:	HEALTH FACILITY ADM.
Telephone Number	:	317-690-4207

Provider Enumeration Date	:	05/18/2010
Last Update Date	:	02/14/2024

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