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General NPI Number Information
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NPI Number | 1558247387
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Entity Type | Organization
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Legal Business Name | REMINGTON MOLECULAR INDIANAPOLIS LLC
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Dates
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Enumeration Date | 08/15/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 2060 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-1762
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Country | US
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Telephone | 630-325-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 540 N DEARBORN ST UNIT 10074
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City | CHICAGO
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State | IL
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Zip | 60610-1016
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | JENNIFER GUAJARDO
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Credential |
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Telephone | 630-943-1201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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