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General NPI Number Information
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NPI Number | 1538668843
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Entity Type | Organization
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Legal Business Name | AERATECH MEDICAL INC
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 5355 W MINNESOTA ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46241-3817
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Country | US
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Telephone | 877-225-2234
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Fax |
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Provider Business Mailing Address
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Address Line | 5355 W MINNESOTA ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46241-3817
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Country | US
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Telephone | 877-225-2234
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ROY L NEELY
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Credential | RRT,
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Telephone | 330-722-1711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 69001408A
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License Number State | IN
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