Provider Demographics
NPI:1063464196
Name:HEALTHMASTERS,INC.
Entity type:Organization
Organization Name:HEALTHMASTERS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-762-0004
Mailing Address - Street 1:3200 WILLOWCREEK RD STE B
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-4486
Mailing Address - Country:US
Mailing Address - Phone:219-762-0004
Mailing Address - Fax:219-762-0082
Practice Address - Street 1:3200 WILLOWCREEK RD STE B
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-4486
Practice Address - Country:US
Practice Address - Phone:219-762-0004
Practice Address - Fax:219-762-0082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN060063891251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100450580Medicaid
IN200032900OtherMEDICAID WAIVER
IN100450580Medicaid