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General NPI Number Information
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NPI Number | 1578513065
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Entity Type | Organization
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Legal Business Name | FORTUNE ENTERPRISES, INC
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 301 E CARMEL DR STE. D200
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City | CARMEL
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State | IN
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Zip | 46032-2888
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Country | US
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Telephone | 317-569-2229
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Fax | 866-437-9987
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Provider Business Mailing Address
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Address Line | 301 E CARMEL DR STE. D200
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City | CARMEL
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State | IN
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Zip | 46032-2888
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Country | US
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Telephone | 317-569-2229
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Fax | 866-437-9987
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GREGORY MCCAULEY
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Credential |
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Telephone | 317-569-2229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | NA
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License Number State | IN
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