Provider Demographics
NPI:1679562458
Name:PREFERRED HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:PREFERRED HOME HEALTH CARE, INC.
Other - Org Name:PREFERRED HOME HEALTH CARE-VINCENNES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAHLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:405-203-2715
Mailing Address - Street 1:2760 AIRPORT DR
Mailing Address - Street 2:STE C
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-2284
Mailing Address - Country:US
Mailing Address - Phone:614-866-8158
Mailing Address - Fax:614-866-8160
Practice Address - Street 1:6920 PARKDALE PLACE
Practice Address - Street 2:STE 110
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-9558
Practice Address - Country:US
Practice Address - Phone:317-245-7236
Practice Address - Fax:317-245-7280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN15D0678755OtherCLIA LICENSE
IN200231350AMedicaid
157318Medicare UPIN