Provider Demographics
NPI:1396002408
Name:INDIANA HOME CARE PHYSICIANS INC
Entity Type:Organization
Organization Name:INDIANA HOME CARE PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZATIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-917-1062
Mailing Address - Street 1:7895 BROADWAY STE V
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5529
Mailing Address - Country:US
Mailing Address - Phone:219-980-3181
Mailing Address - Fax:219-359-1837
Practice Address - Street 1:7895 BROADWAY STE V
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5529
Practice Address - Country:US
Practice Address - Phone:219-980-3181
Practice Address - Fax:219-359-1837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty