NPIMap

Organization Active NPI

Home Health Depot

  • Customized Equipment (DME)
  • Bloomington, IL
National Provider Identifier
1639479140
Registry record updated Oct 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
HOME HEALTH DEPOT
Practice address
13 Westport CT
Unit B
Bloomington, IL 61704-3626
Phone
(309) 662-4000
Fax
(317) 333-6034
NPI assigned
Oct 31, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2010

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

13 Westport CT
Unit B
Bloomington, IL 61704-3626

Mailing address

9245 N Meridian St
Suite 200
Indianapolis, IN 46260-1836
Phone (317) 333-6033

National Provider Directory

National Provider Directory
Tax ID family
Home Health Depot Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

13 Westport Ct
#B
Bloomington, IL 61704
Phone (309) 662-4000

NPI Registry JSON

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

{
    "created_epoch": "1288483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288483200000",
    "number": "1639479140",
    "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": "13 WESTPORT CT",
            "address_2": "UNIT B",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043626",
            "telephone_number": "309-662-4000",
            "fax_number": "317-333-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME HEALTH DEPOT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-31",
        "last_updated": "2010-10-31",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2010; 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.