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1457387060

NPI Code Detail

MEDICARE: HOOSIER CARE III, INC.

MEDICARE: HOOSIER CARE III, INC.

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	314000000X	Skilled Nursing Facility	1031	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11100	OTHER		ELDER HEALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0117439	OTHER		AETNA-HMO
4	PN5	OTHER		CAREFIRST IND/PPO
5	021I	OTHER		CAREFIRST - PROV/INQ#
6	0004639000	OTHER		IBC
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	0004639000	OTHER		AMERIHEALTH
9	PN5	OTHER		CAREFIRST - BLUE CHOICE
10	245082	OTHER		UNITED MAMSI
11	71-01244	OTHER		UNITED - EVERCARE
12	155031	OTHER		BC/BS OF DELAWARE

General Provider Information

NPI Number	:	1457387060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOOSIER CARE III, INC.

Provider Business Mailing Address
First Line	:	3200 SYCAMORE CT
Second Line	:	SUITE 113
City	:	COLUMBUS
State	:	IN
Zip	:	47203-1545
Country	:	US
Telephone Number	:	812-378-9027
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 SYCAMORE CT
Second Line	:	SUITE 113
City	:	COLUMBUS
State	:	IN
Zip	:	47203-1545
Country	:	US
Telephone Number	:	812-378-9027
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	REBECCA J. BLEVINS
Credential	:
Telephone Number	:	812-378-9027

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	07/21/2022

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Directions to “HOOSIER CARE III, INC. ” Practice Location

Language	Start Address	Practice Location

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