Basic Information
Provider Information
NPI: 1366849846
EntityType: 2
ReplacementNPI:  
OrganizationName: INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 950 N MERIDIAN ST
Address2: SUITE 800
City: INDIANAPOLIS
State: IN
PostalCode: 462041077
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2401 W UNIVERSITY AVE
Address2:  
City: MUNCIE
State: IN
PostalCode: 473033428
CountryCode: US
TelephoneNumber: 7657473111
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/26/2014
LastUpdateDate: 11/26/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: LUTHER
AuthorizedOfficialFirstName: LORI
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 7657512795
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
341600000X  Y Transportation ServicesAmbulance 

No ID Information.


Home