Healthcare Provider Details

I. General information

NPI: 1780550384
Provider Name (Legal Business Name): VANNUCHI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1846 SOUTHERNWOOD LN
INDIANAPOLIS IN
46231-5210
US

IV. Provider business mailing address

1846 SOUTHERNWOOD LN
INDIANAPOLIS IN
46231-5210
US

V. Phone/Fax

Practice location:
  • Phone: 317-560-4451
  • Fax:
Mailing address:
  • Phone: 317-560-4451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: OBIANUJU NDUBUOKWU
Title or Position: MD/CEO
Credential:
Phone: 317-560-4451