Provider Demographics
NPI:1902236789
Name:ABSOLUTE HOME MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:ABSOLUTE HOME MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-357-3575
Mailing Address - Street 1:4742 E 10TH ST
Mailing Address - Street 2:A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46201-2826
Mailing Address - Country:US
Mailing Address - Phone:317-357-3575
Mailing Address - Fax:317-357-3575
Practice Address - Street 1:4742 E 10TH ST
Practice Address - Street 2:A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201-2826
Practice Address - Country:US
Practice Address - Phone:317-357-3575
Practice Address - Fax:317-357-3575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies