Organization · NPI-2

Active Home Care LLC

Durable Medical Equipment & Medical Supplies · Indianapolis, IN

NPI number1730312232
StatusActive
Last updated in NPPESFeb 24, 2014

Details

NPI
1730312232
Entity type
Organization (NPI-2)
Legal business name
Active Home Care LLC
Organization subpart
No
Enumeration date
Aug 31, 2009
Last updated
Feb 24, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332B00000X Durable Medical Equipment & Medical Supplies69000564AINYes

Practice location

5980 W 71st St
Suite 203
Indianapolis, IN 46278-2711

Phone 317-328-2866 · Fax 317-534-0578

Mailing address

5980 W 71st St
Suite 203
Indianapolis, IN 46278-2711

Phone 317-328-2866 · Fax 317-534-0578

Authorized official

Richard L Johnson
President
3173282866

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