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General NPI Number Information
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NPI Number | 1093933236
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Entity Type | Organization
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Legal Business Name | STATE OF INDIANA - AUDITOR OF STATE
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 498 NW 18TH ST
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City | RICHMOND
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State | IN
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Zip | 47374-2851
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Country | US
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Telephone | 765-966-0511
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Fax | 765-935-9503
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Provider Business Mailing Address
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Address Line | 498 NW 18TH ST
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City | RICHMOND
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State | IN
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Zip | 47374-2851
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Country | US
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Telephone | 765-966-0511
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Fax | 765-935-9507
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Authorized Official
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Title or Position | ASSISTANT SUPERINTENDENT
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Name | DAVID M SHELFORD
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Credential |
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Telephone | 765-935-9206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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