MEDICARE: ABC HOME HEALTH INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	163WH0200X	Home Health Registered Nurse
2	251F00000X	Home Infusion Agency
3	251G00000X	Community Based Hospice Care Agency
4	251J00000X	Nursing Care Agency
5	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376282798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC HOME HEALTH INC.

Provider Business Mailing Address
First Line	:	570 W 15TH ST
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83402-4269
Country	:	US
Telephone Number	:	208-525-6104
Fax Number	:	208-525-6106

Provider Business Practice Location Address
First Line	:	570 W 15TH ST
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83402-4269
Country	:	US
Telephone Number	:	208-525-6104
Fax Number	:	208-525-6106

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PARALEA FURNISS
Credential	:
Telephone Number	:	208-200-6100

Provider Enumeration Date	:	06/02/2022
Last Update Date	:	06/02/2022

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Directions to “ABC HOME HEALTH INC. ” Practice Location

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