Provider Demographics
NPI:1306141874
Name:HOUSE CALLS MEDICAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:HOUSE CALLS MEDICAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-661-3378
Mailing Address - Street 1:6201 LA PAS TRL STE 265
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-4869
Mailing Address - Country:US
Mailing Address - Phone:317-297-0307
Mailing Address - Fax:317-297-7895
Practice Address - Street 1:6201 LA PAS TRL STE 265
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-4869
Practice Address - Country:US
Practice Address - Phone:317-297-0307
Practice Address - Fax:317-297-7895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201043580AMedicaid
INM100038847Medicare PIN