Basic Information
Provider Information
NPI: 1003543075
EntityType: 2
ReplacementNPI:  
OrganizationName: THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
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Mailing Information
Address1: 720 ESKENAZI AVE
Address2: FIFTH THIRD BANK BLDG, 5TH FL
City: INDIANAPOLIS
State: IN
PostalCode: 462025166
CountryCode: US
TelephoneNumber: 3178803818
FaxNumber: 3178800343
Practice Location
Address1: 2620 KESSLER BOULEVARD EAST DR STE 210
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462202889
CountryCode: US
TelephoneNumber: 3178800000
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Other Information
ProviderEnumerationDate: 08/01/2022
LastUpdateDate: 08/01/2022
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AuthorizedOfficialLastName: SCOTT
AuthorizedOfficialFirstName: CHRISTOPHER
AuthorizedOfficialMiddleName: M
AuthorizedOfficialTitleorPosition: CHIEF CLINICAL AND REVENUE OFFICER
AuthorizedOfficialTelephone: 3178804440
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: PHARMD
NPICertificationDate: 08/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X  Y193200000X MULTI-SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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