Basic Information
| Provider Information | |||||||||
| NPI: | 1114905882 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HAMILTONS HEALTH AID SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 142 E COLLINS RD | ||||||||
| Address2: | |||||||||
| City: | FT WAYNE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 468255302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2604715011 | ||||||||
| FaxNumber: | 2604715109 | ||||||||
| Practice Location | |||||||||
| Address1: | 142 E COLLINS RD | ||||||||
| Address2: | |||||||||
| City: | FT WAYNE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 468255302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2604715011 | ||||||||
| FaxNumber: | 2604715109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2006 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | ROBERTS | ||||||||
| AuthorizedOfficialFirstName: | KATHLEEN | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5139233300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 163326 | 05 | IN | MEDICAID | 7593 | 01 | IN | PHP | OTHER | 1024316 | 01 | IN | ACM/UHC | OTHER | 270117 | 01 | IN | HARMONY | OTHER | 000000216355 | 01 | IN | ANTHEM | OTHER | 51533 | 01 | IN | ABP | OTHER | 2421623 | 05 | OH | MEDICAID |