MEDICARE: MOORE HOME HEALTH CARE, 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	251E00000X	Home Health Agency	06-009757-1	IN

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
2	200112780A	OTHER	IN	WAIVER

General Provider Information

NPI Number	:	1497807358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOORE HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	9000 INDIANAPOLIS BLVD STE A
Second Line	:
City	:	HIGHLAND
State	:	IN
Zip	:	46322-2501
Country	:	US
Telephone Number	:	219-923-2655
Fax Number	:	219-923-2640

Provider Business Practice Location Address
First Line	:	9000 INDIANAPOLIS BLVD STE A
Second Line	:
City	:	HIGHLAND
State	:	IN
Zip	:	46322-2501
Country	:	US
Telephone Number	:	219-923-2655
Fax Number	:	219-923-2640

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LUDEEN ANGELETY-MOORE
Credential	:	RN
Telephone Number	:	219-392-6858

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	09/17/2009

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Directions to “MOORE HOME HEALTH CARE, INC. ” Practice Location

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