Provider Demographics
NPI:1598872939
Name:SUBURBAN HOME HEALTH, LLC
Entity Type:Organization
Organization Name:SUBURBAN HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-468-2011
Mailing Address - Street 1:14297 BERGEN BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-3398
Mailing Address - Country:US
Mailing Address - Phone:317-468-2010
Mailing Address - Fax:317-477-0086
Practice Address - Street 1:14297 BERGEN BLVD STE 250
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-3398
Practice Address - Country:US
Practice Address - Phone:317-468-2010
Practice Address - Fax:317-477-0086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1598872939OtherNPI
IN201241090AMedicaid
IN1598872939OtherNPI