Provider Demographics
NPI:1154451193
Name:INDIGO HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:INDIGO HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:OSAYAREN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:702-492-1010
Mailing Address - Street 1:9975 S EASTERN AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89123-7949
Mailing Address - Country:US
Mailing Address - Phone:702-492-1010
Mailing Address - Fax:702-492-6998
Practice Address - Street 1:9975 S EASTERN AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89123-7949
Practice Address - Country:US
Practice Address - Phone:702-492-1010
Practice Address - Fax:702-492-6998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV4364610001Medicare ID - Type Unspecified