Basic Information
| Provider Information | |||||||||
| NPI: | 1568842490 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ESKENAZI HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 163 N 500 W | ||||||||
| Address2: | |||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460111434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7652085932 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1001 W 10TH ST | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462022859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178800000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2015 | ||||||||
| LastUpdateDate: | 06/05/2015 | ||||||||
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| AuthorizedOfficialLastName: | OTT | ||||||||
| AuthorizedOfficialFirstName: | ESTA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIAL SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 3178804104 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | IN | Y | Hospitals | General Acute Care Hospital |
No ID Information.