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General NPI Number Information
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NPI Number | 1174754899
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Entity Type | Organization
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Legal Business Name | INDIANA SLEEP AND RESPIRATORY CARE, INC
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 1428 10TH ST SUITE 1A
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City | COLUMBUS
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State | IN
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Zip | 47201-5906
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Country | US
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Telephone | 812-961-0153
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Fax | 812-961-0155
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Provider Business Mailing Address
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Address Line | PO BOX 1507
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City | MADISON
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State | IN
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Zip | 47250-1507
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Country | US
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Telephone | 812-961-0153
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Fax | 812-961-0155
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MR. TIMOTHY FORD
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Credential |
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Telephone | 513-403-6464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 69000502A
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License Number State | IN
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