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General NPI Number Information
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NPI Number | 1265228548
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Entity Type | Organization
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Legal Business Name | ADS OF IN LLC
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 2441 STATE ST STE C
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City | NEW ALBANY
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State | IN
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Zip | 47150-4984
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Country | US
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Telephone | 812-920-8726
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Fax |
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Provider Business Mailing Address
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Address Line | 10300 LINN STATION RD FL 1
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City | LOUISVILLE
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State | KY
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Zip | 40223-3840
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Country | US
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Telephone | 502-254-8500
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | JEFFREY REIBEL
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Credential |
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Telephone | 502-254-8526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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