Healthcare Provider Details

I. General information

NPI: 1144708413
Provider Name (Legal Business Name): INJECT HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 07/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1833 N SHADELAND AVE
INDIANAPOLIS IN
46219-2735
US

IV. Provider business mailing address

1221 S CREASY LN STE K3
LAFAYETTE IN
47905-7430
US

V. Phone/Fax

Practice location:
  • Phone: 765-838-2310
  • Fax: 317-559-5971
Mailing address:
  • Phone: 317-965-6515
  • Fax: 317-559-5971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: SUSAN ROBERTSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 317-965-6515