Healthcare Provider Details

I. General information

NPI: 1295928299
Provider Name (Legal Business Name): RILEY CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 08/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 BARNHILL DR ROOM 5960
INDIANAPOLIS IN
46202-5128
US

IV. Provider business mailing address

702 BARNHILL DR ROOM 5960
INDIANAPOLIS IN
46202
US

V. Phone/Fax

Practice location:
  • Phone: 317-274-0195
  • Fax: 317-278-2760
Mailing address:
  • Phone: 317-274-0195
  • Fax: 317-278-2760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number28107268A
License Number StateIN

VIII. Authorized Official

Name: MRS. LINDA DARLENE STROUD
Title or Position: CDE
Credential: RN CPNP
Phone: 317-274-0195