Home Health Depot Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

203.000752 Issued in IL

Legal business name

HOME HEALTH DEPOT INC

Practice address

2101 W Cermak Rd
Broadview, IL 60155-4605

Phone

(708) 345-2466

Fax

(708) 345-2865

NPI assigned

Oct 31, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Terri Goldman

Title

Director of Contracting

Phone

(317) 333-6033

Specialties & licenses 6

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498780800000",
    "number": "1174823686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9245 N MERIDIAN ST",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601836",
            "telephone_number": "317-333-6033",
            "fax_number": "317-333-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 W CERMAK RD",
            "city": "BROADVIEW",
            "state": "IL",
            "postal_code": "601554605",
            "telephone_number": "708-345-2466",
            "fax_number": "708-345-2865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME HEALTH DEPOT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-31",
        "last_updated": "2017-06-30",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING",
        "authorized_official_telephone_number": "317-333-6033",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "203.001283",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "69000860A",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IL",
            "license": "203.000752",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IN",
            "license": "69000860A",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IL",
            "license": "203.001283",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IN",
            "license": "69000860A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healthcare Alternative Systems, Inc.
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• Highland Park CVS LLC
• Kenneth Lyle Holland, APRN
• Terri Howe, BSW
• Robert H Jansen Jr.
• Just Smiles LTD
• Jason L Kay, PHARM.D.
• Eric Kelley, MD

• All providers in Broadview, IL
• Customized Equipment (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.