Provider Demographics
NPI:1114993490
Name:COMMUNITY HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:COMMUNITY HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO HME
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:317-621-4810
Mailing Address - Street 1:9894 E 121ST ST
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-4154
Mailing Address - Country:US
Mailing Address - Phone:317-621-4800
Mailing Address - Fax:317-621-4811
Practice Address - Street 1:9894 E 121ST ST
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-4154
Practice Address - Country:US
Practice Address - Phone:317-621-4800
Practice Address - Fax:317-621-4811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HOME HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-27
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60004988A251F00000X
332B00000X, 332BP3500X, 3336H0001X
IN69000274A332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251F00000XAgenciesHome Infusion
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000214624OtherANTHEM BLUE CROSS AND BLU
IN000000011033OtherMPLAN
IN000000011142OtherMPLAN
IN200189320AMedicaid
IN000000107707OtherANTHEM BLUE CROSS AND BLU
IN1280120001Medicare NSC