1578887386 NPI number — INDIANA UNIVERSITY HEALTH, INC

Table of content: (NPI 1578887386)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578887386 NPI number — INDIANA UNIVERSITY HEALTH, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INDIANA UNIVERSITY HEALTH, INC
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:
INDIANA UNIVERSITY HEALTH BALL MEMORIAL SLEEP APNEA EDUCATION CENTER
Provider Other Organization Name Type Code:
3
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:
1578887386
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
12/20/2013
NPI Reactivation Date:
11/30/2016

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
950 N MERIDIAN ST STE 700
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:
46204-1236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-962-4600
Provider Business Mailing Address Fax Number:
317-962-4646

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6004 W KILGORE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MUNCIE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47304-4726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-802-9791
Provider Business Practice Location Address Fax Number:
888-803-9861
Provider Enumeration Date:
03/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
ALVEY
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
M
Authorized Official Title or Position:
SVP/CFO
Authorized Official Telephone Number:
317-963-0213

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  69001369A , 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: 201097830A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com