Provider Demographics
NPI:1285388942
Name:HOOSIER HEALTH MEDICAL SUPPLIES
Entity type:Organization
Organization Name:HOOSIER HEALTH MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-996-3433
Mailing Address - Street 1:2006 PADDLE WHEEL CT APT 125
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-6874
Mailing Address - Country:US
Mailing Address - Phone:502-996-3433
Mailing Address - Fax:888-877-2441
Practice Address - Street 1:2006 PADDLE WHEEL CT APT 125
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-6874
Practice Address - Country:US
Practice Address - Phone:502-996-3433
Practice Address - Fax:888-877-2441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies