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General NPI Number Information
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NPI Number | 1578628327
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Entity Type | Organization
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Legal Business Name | HOOSIER ENTERPRISES V, INC.
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3550 CENTRAL AVE
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City | COLUMBUS
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State | IN
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Zip | 47203-2035
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Country | US
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Telephone | 812-379-9669
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Fax | 812-378-5248
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Provider Business Mailing Address
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Address Line | 9455 DELEGATES ROW
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-3805
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Country | US
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Telephone | 317-818-1240
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Fax | 317-818-1240
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Authorized Official
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Title or Position | AR MANAGER
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Name | WILLIAM MUELLER
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Credential |
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Telephone | 317-818-1240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | IN
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