Provider Demographics
NPI:1144651860
Name:HOME HEALTH DEPOT, INC.
Entity type:Organization
Organization Name:HOME HEALTH DEPOT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARTLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:317-333-6033
Mailing Address - Street 1:9245 N MERIDIAN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1836
Mailing Address - Country:US
Mailing Address - Phone:317-333-6033
Mailing Address - Fax:317-333-6034
Practice Address - Street 1:1428 10TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5906
Practice Address - Country:US
Practice Address - Phone:812-565-5350
Practice Address - Fax:812-565-5351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-05
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X, 332BP3500X, 332BX2000X
IN69001173A332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies