Provider Demographics
NPI:1003805631
Name:PREFERRED HOME HEALTH CARE - VINCENNES, INC
Entity Type:Organization
Organization Name:PREFERRED HOME HEALTH CARE - VINCENNES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-745-5500
Mailing Address - Street 1:5250 E US HIGHWAY 36
Mailing Address - Street 2:SUITE 800
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-9199
Mailing Address - Country:US
Mailing Address - Phone:317-745-5500
Mailing Address - Fax:317-745-5559
Practice Address - Street 1:5250 E US HIGHWAY 36
Practice Address - Street 2:SUITE 800
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-9199
Practice Address - Country:US
Practice Address - Phone:317-745-5500
Practice Address - Fax:317-745-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200235000AMedicaid
IN=========OtherINSURANCE
IN157193Medicare ID - Type Unspecified