1386777373 NPI number — CENTER FOR WOMEN'S HEALTH IMAGING

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386777373 NPI number — CENTER FOR WOMEN'S HEALTH IMAGING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR WOMEN'S HEALTH IMAGING
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:
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:
1386777373
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5901 TECHNOLOGY CENTER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46278-6013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-328-5050
Provider Business Mailing Address Fax Number:
317-715-9965

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
533 EAST COUNTY LINE ROAD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
GREENWOOD
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-328-5050
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WILGUS
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
EXECTIVE DIRECTOR
Authorized Official Telephone Number:
317-328-5050

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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