Healthcare Provider Details

I. General information

NPI: 1609873124
Provider Name (Legal Business Name): INDIANAPOLIS OSTEOPATHIC HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3630 GUION ROAD
INDIANAPOLIS IN
46222-1616
US

IV. Provider business mailing address

3630 GUION RD
INDIANAPOLIS IN
46222-1616
US

V. Phone/Fax

Practice location:
  • Phone: 371-920-8439
  • Fax: 317-920-7551
Mailing address:
  • Phone: 371-920-7195
  • Fax: 317-920-7551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateIN

VIII. Authorized Official

Name: MS. DEANN C GARRISON
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 317-920-7474