Provider Demographics
NPI:1376282798
Name:ABC HOME HEALTH INC.
Entity Type:Organization
Organization Name:ABC HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PARALEA
Authorized Official - Middle Name:
Authorized Official - Last Name:FURNISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-200-6100
Mailing Address - Street 1:570 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83402-4269
Mailing Address - Country:US
Mailing Address - Phone:208-525-6104
Mailing Address - Fax:208-525-6106
Practice Address - Street 1:570 W 15TH ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83402-4269
Practice Address - Country:US
Practice Address - Phone:208-525-6104
Practice Address - Fax:208-525-6106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1924Medicaid