MEDICARE: GANT FAMILY HOME HEALTH CARE 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	:	1902621279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GANT FAMILY HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	3418 E 20TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-4402
Country	:	US
Telephone Number	:	317-448-0271
Fax Number	:	317-602-8124

Provider Business Practice Location Address
First Line	:	3418 E 20TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-4402
Country	:	US
Telephone Number	:	317-448-0271
Fax Number	:	317-602-8124

Authorized Official
Title or Position	:	CEO
Name	:	BRITTNEY GANT
Credential	:	NP
Telephone Number	:	317-448-0271

Provider Enumeration Date	:	11/20/2024
Last Update Date	:	11/20/2024

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