Provider Demographics
NPI:1033492996
Name:HOME HEALTH DEPOT INC
Entity Type:Organization
Organization Name:HOME HEALTH DEPOT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CONTRACTING
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-333-6033
Mailing Address - Street 1:9245 N MERIDIAN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1836
Mailing Address - Country:US
Mailing Address - Phone:317-333-6033
Mailing Address - Fax:317-333-6034
Practice Address - Street 1:7040 GUION RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-4812
Practice Address - Country:US
Practice Address - Phone:317-347-6400
Practice Address - Fax:317-347-6409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-27
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment