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General NPI Number Information
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NPI Number | 1346239696
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Entity Type | Organization
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Legal Business Name | PURDUE UNIVERSITY
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 601 STADIUM MALL DR
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City | WEST LAFAYETTE
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State | IN
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Zip | 47907-2052
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Country | US
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Telephone | 765-494-1700
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Fax | 765-496-1227
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Provider Business Mailing Address
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Address Line | 601 STADIUM MALL DR
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City | WEST LAFAYETTE
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State | IN
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Zip | 47907-2052
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Country | US
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Telephone | 765-494-1700
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Fax | 765-496-1227
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Authorized Official
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Title or Position | DIRECTOR HIPAA PRIVACY COMPLIANCE
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Name | MS. JOAN M VAUGHAN
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Credential |
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Telephone | 765-496-1927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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