Provider Demographics
NPI:1962675561
Name:INDIANAPOLIS HOME CARE, INC
Entity Type:Organization
Organization Name:INDIANAPOLIS HOME CARE, INC
Other - Org Name:INTERIM HEALTHCARE OF INDIANAPOLIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-436-9404
Mailing Address - Street 1:373 MERIDIAN PARKE LN STE A1
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-9400
Mailing Address - Country:US
Mailing Address - Phone:317-755-1687
Mailing Address - Fax:317-992-2266
Practice Address - Street 1:373 MERIDIAN PARKE LN STE A1
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-9400
Practice Address - Country:US
Practice Address - Phone:317-755-1687
Practice Address - Fax:317-992-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07-006364-2251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200888320AOtherMEDICAID WAIVER
IN200885920AMedicaid
IN200885920AMedicaid