1083880447 NPI number — BIOTEL INR, LLC

Table of content: (NPI 1083880447)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083880447 NPI number — BIOTEL INR, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIOTEL INR, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083880447
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 CEDAR HOLLOW RD STE 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MALVERN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19355-2300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-729-5066
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9115 HAGUE RD
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46256-1025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-521-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MCNAMARA
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
610-729-0504

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  0105509540 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 293D00000X , with the licence number: 0105509540 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 258200 . This is a "MEDICARE PTAN" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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