1376598078 NPI number — GRANT COUNTY AUDITOR

Table of content: DR. LYNDA LU HULST MD (NPI 1811942519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376598078 NPI number — GRANT COUNTY AUDITOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GRANT COUNTY AUDITOR
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:
1376598078
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 S ADAMS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARION
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46953-2037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
765-674-6592
Provider Business Mailing Address Fax Number:
765-674-7037

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3921 S GARTHWAITE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GAS CITY
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46933-1155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-674-6592
Provider Business Practice Location Address Fax Number:
765-674-7037
Provider Enumeration Date:
05/23/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HARNESS
Authorized Official First Name:
DAWN
Authorized Official Middle Name:
RENEE
Authorized Official Title or Position:
BILLING ADMINSTRATOR
Authorized Official Telephone Number:
765-674-6592

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  0332 , 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: 000000184723 . This is a "EMERGENCY AMBULANCE SERVI" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 100287040 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".