Healthcare Provider Details

I. General information

NPI: 1376430595
Provider Name (Legal Business Name): IRMT PA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5610 CRAWFORDSVILLE RD STE 2100
INDIANAPOLIS IN
46224-3787
US

IV. Provider business mailing address

5610 CRAWFORDSVILLE RD STE 2100
INDIANAPOLIS IN
46224-3787
US

V. Phone/Fax

Practice location:
  • Phone: 317-444-1231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: LINDA COSBY
Title or Position: DIRECTOR
Credential:
Phone: 317-444-1231