MEDICARE: GARLANDA HATTER

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	12-01284-1	IN

General Provider Information

NPI Number	:	1639430044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARLANDA HATTER

Provider Business Mailing Address
First Line	:	7710 TARDELLI LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46214-2358
Country	:	US
Telephone Number	:	317-652-0482
Fax Number	:

Provider Business Practice Location Address
First Line	:	7710 TARDELLI LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46214-2358
Country	:	US
Telephone Number	:	317-652-0482
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	GARLANDA HATTER
Credential	:
Telephone Number	:	317-652-0482

Provider Enumeration Date	:	06/01/2012
Last Update Date	:	06/01/2012

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