Provider Demographics
NPI:1639388036
Name:NET MED SUPPLY
Entity Type:Organization
Organization Name:NET MED SUPPLY
Other - Org Name:APEX HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PANKAJ
Authorized Official - Middle Name:K
Authorized Official - Last Name:TYAGI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:812-201-1338
Mailing Address - Street 1:4417 S HIDDEN WAY ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-6602
Mailing Address - Country:US
Mailing Address - Phone:812-299-5828
Mailing Address - Fax:812-299-0203
Practice Address - Street 1:4417 S HIDDEN WAY ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-6602
Practice Address - Country:US
Practice Address - Phone:812-299-5828
Practice Address - Fax:812-299-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31001448A251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health