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NPI Code Detail

MEDICARE: INDICARE HOME HEALTH LLC

MEDICARE: INDICARE 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1891394813
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDICARE HOME HEALTH LLC
Provider Business Mailing Address
First Line : 1406 FORT CROOK RD S STE 410
Second Line :
City : BELLEVUE
State : NE
Zip : 68005-2980
Country : US
Telephone Number : 402-968-1600
Fax Number :
Provider Business Practice Location Address
First Line : 1406 FORT CROOK RD S STE 410
Second Line :
City : BELLEVUE
State : NE
Zip : 68005-2980
Country : US
Telephone Number : 402-968-1600
Fax Number :
Authorized Official
Title or Position : OWNER/ADMINISTRATOR
Name : ISHEEA BULTEZ
Credential :
Telephone Number : 402-968-1600
Provider Enumeration Date : 10/21/2020
Last Update Date : 10/29/2020

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Directions to “INDICARE HOME HEALTH LLC ” Practice Location

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