1871514075 NPI number — CARDINAL HEALTH SYSTEMS

Table of content: (NPI 1871514075)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871514075 NPI number — CARDINAL HEALTH SYSTEMS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDINAL HEALTH SYSTEMS
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:
BALL MEMORIAL HOSPITAL
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:
1871514075
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2401 W UNIVERSITY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MUNCIE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47303-3428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
765-741-1592
Provider Business Mailing Address Fax Number:
765-747-3841

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 FOREST RIDGE PKWY
Provider Second Line Business Practice Location Address:
STE#320
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47362-2943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-593-2977
Provider Business Practice Location Address Fax Number:
765-593-2976
Provider Enumeration Date:
07/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GILDERSLEEVE
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICIER
Authorized Official Telephone Number:
765-747-3367

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X , with the licence number:  010644 , 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: 000000295082 . This is a "BALL DIALYSIS AT HENRY CO" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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