Healthcare Provider Details

I. General information

NPI: 1942303086
Provider Name (Legal Business Name): INDIANA HEALTH CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8003 CASTLEWAY DR
INDIANAPOLIS IN
46250
US

IV. Provider business mailing address

8003 CASTLEWAY DRIVE
INDIANAPOLIS IN
46250
US

V. Phone/Fax

Practice location:
  • Phone: 317-576-1335
  • Fax: 317-576-1339
Mailing address:
  • Phone: 317-576-1335
  • Fax: 317-576-1339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. TRACEY NAGEL
Title or Position: CFO
Credential:
Phone: 317-576-1335