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NPI Code Detail

MEDICARE: OPIOID MANAGEMENT LLC

MEDICARE: OPIOID MANAGEMENT LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QA0401XAddiction Medicine (Family Medicine) Physician
2363LF0000XFamily Nurse Practitioner
3363LG0600XGerontology Nurse Practitioner
4363LP2300XPrimary Care Nurse Practitioner
5208VP0000XPain Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811351778
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPIOID MANAGEMENT LLC
Provider Business Mailing Address
First Line : 821 N STATE ROAD 135
Second Line :
City : GREENWOOD
State : IN
Zip : 46142-1314
Country : US
Telephone Number : 317-560-4300
Fax Number : 317-530-9084
Provider Business Practice Location Address
First Line : 821 N STATE ROAD 135
Second Line :
City : GREENWOOD
State : IN
Zip : 46142-1314
Country : US
Telephone Number : 317-560-4300
Fax Number : 317-530-9084
Authorized Official
Title or Position : OWNER
Name : DR. SIMON FU FENG
Credential :
Telephone Number : 317-560-4300
Provider Enumeration Date : 04/07/2016
Last Update Date : 12/31/2024

Similar Medicare Providers

1649274317 — DR. SIMON FU FENG MD
Practice Location Address:
821 N STATE ROAD 135
GREENWOOD, IN
46142-1314
Practice Phone: 317-560-4300
Practice Fax: 317-530-9084
1649271347 — SAMANTHA J SERIGHT FNP
Practice Location Address:
821 N STATE ROAD 135
GREENWOOD, IN
46142-1314
Practice Phone: 317-560-4300
Practice Fax: 317-530-9084
1114179900 — ASHLEY N SPARKS FNP-C
Practice Location Address:
821 N STATE ROAD 135
GREENWOOD, IN
46142-1314
Practice Phone: 317-560-4300
Practice Fax: 317-530-9084
1871900498 — MRS. STACEY MICHELLE ENGEL NP
Practice Location Address:
821 N STATE ROAD 135
GREENWOOD, IN
46142-1314
Practice Phone: 317-560-4300
Practice Fax: 317-530-9084
1104281344 — MS. JENNIFER DAWN STYER FNP
Practice Location Address:
821 N STATE ROAD 135
GREENWOOD, IN
46142-1314
Practice Phone: 317-560-4300
Practice Fax: 317-530-9084
1104322395 — SARAH LUCILLE GODSAVE NP
Practice Location Address:
821 N STATE ROAD 135
GREENWOOD, IN
46142-1314
Practice Phone: 317-560-4300
Practice Fax: 317-530-9084

Directions to “OPIOID MANAGEMENT LLC ” Practice Location

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