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General NPI Number Information
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NPI Number | 1447408505
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Entity Type | Organization
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Legal Business Name | SUBODH C. DEBNATH
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 408 W MARKET ST
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-1600
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Country | US
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Telephone | 765-362-4893
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Fax | 765-362-6524
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Provider Business Mailing Address
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Address Line | 408 W MARKET ST
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-1600
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Country | US
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Telephone | 765-362-4893
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Fax | 765-362-6524
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUBODH C. DEBNATH,
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Credential | MD
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Telephone | 765-362-4893
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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 | 01031718
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License Number State | IN
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