Basic Information
| Provider Information | |||||||||
| NPI: | 1548512213 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLCARE RHEUMATOLOGY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 68952 | ||||||||
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| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462680952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178700480 | ||||||||
| FaxNumber: | 3178700499 | ||||||||
| Practice Location | |||||||||
| Address1: | 18077 RIVER AVE | ||||||||
| Address2: | |||||||||
| City: | NOBLESVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460628303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172146420 | ||||||||
| FaxNumber: | 3172146015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2012 | ||||||||
| LastUpdateDate: | 10/05/2012 | ||||||||
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| AuthorizedOfficialLastName: | TRAN | ||||||||
| AuthorizedOfficialFirstName: | TRINH | ||||||||
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| AuthorizedOfficialTitleorPosition: | AUTHORIZED REPRESENTATIVE | ||||||||
| AuthorizedOfficialTelephone: | 3172146420 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.