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General NPI Number Information
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NPI Number | 1184243206
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Entity Type | Organization
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Legal Business Name | AMERICAN HEALTH NETWORK OF INDIANA, LLC
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 04/09/2020
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Provider Practice Location Address
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Address Line | 2108 STATE ST STE 200
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City | NEW ALBANY
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State | IN
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Zip | 47150-4923
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Country | US
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Telephone | 812-542-5633
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Fax | 812-542-1904
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Provider Business Mailing Address
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Address Line | 2108 STATE ST STE 200
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City | NEW ALBANY
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State | IN
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Zip | 47150-4923
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Country | US
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Telephone | 812-542-5633
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Fax | 812-542-1904
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | BEN H PARK
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Credential | MD
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Telephone | 317-580-6303
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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 |
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License Number State |
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