NPIMap

Organization Active NPI

Home Health Depot Inc

  • Durable Medical Equipment & Medical Supplies
  • Bloomington, IL
National Provider Identifier
1750682738
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
203.001290 Issued in IL
Legal business name
HOME HEALTH DEPOT INC
Practice address
105 Krispy Kreme Dr
Suite 3
Bloomington, IL 61704-3751
Phone
(309) 662-4606
Fax
(309) 663-1916
NPI assigned
Nov 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Authorized official

Name
Terri Goldman
Title
Director of Contracting
Phone
(317) 333-6033

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 203.001290 IL Primary
Customized Equipment (DME) 332BC3200X 203.001290 IL
Oxygen Equipment & Supplies (DME) 332BX2000X 203.001290 IL

Addresses

Primary practice location

105 Krispy Kreme Dr
Suite 3
Bloomington, IL 61704-3751

Mailing address

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1750682738",
    "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": "105 KRISPY KREME DR",
            "address_2": "SUITE 3",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043751",
            "telephone_number": "309-662-4606",
            "fax_number": "309-663-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME HEALTH DEPOT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2012-01-09",
        "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"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "203.001290",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IL",
            "license": "203.001290",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IL",
            "license": "203.001290",
            "primary": false
        }
    ],
    "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 Jan 9, 2012; 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.