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General NPI Number Information
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NPI Number | 1205816832
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Entity Type | Organization
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Legal Business Name | INDIANA HEART HOSPITAL, LLC
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 03/28/2013
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Provider Practice Location Address
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Address Line | 8075 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2693
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Country | US
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Telephone | 317-621-8000
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Fax | 317-621-8111
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Provider Business Mailing Address
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Address Line | 6233 RELIABLE PKWY
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City | CHICAGO
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State | IL
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Zip | 60686-0062
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Country | US
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Telephone | 317-621-8000
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Fax | 317-621-8111
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MS. MARY GAMACHE
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Credential |
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Telephone | 317-621-8057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 003312
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License Number State | IN
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