MEDICARE: COREMED HOME HEALTH 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1417834631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COREMED HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	2346 S LYNHURST DR STE B105E
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46241-8620
Country	:	US
Telephone Number	:	317-287-9502
Fax Number	:	317-554-2174

Provider Business Practice Location Address
First Line	:	2346 S LYNHURST DR STE B105E
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46241-8620
Country	:	US
Telephone Number	:	317-287-9502
Fax Number	:	317-554-2174

Authorized Official
Title or Position	:	OWNER
Name	:	ITASKA SHOFFNER
Credential	:
Telephone Number	:	317-287-9502

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	08/19/2025

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