Healthcare Provider Details

I. General information

NPI: 1427617927
Provider Name (Legal Business Name): RALANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2019
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1463 DANIELLE DR
INDIANAPOLIS IN
46231-1612
US

IV. Provider business mailing address

1463 DANIELLE DR
INDIANAPOLIS IN
46231-1612
US

V. Phone/Fax

Practice location:
  • Phone: 317-429-7950
  • Fax:
Mailing address:
  • Phone: 317-704-4728
  • Fax: 317-421-7904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: RITA I ODOLE
Title or Position: MEMBER
Credential:
Phone: 317-429-7950