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General NPI Number Information
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NPI Number | 1730040395
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Entity Type | Organization
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Legal Business Name | IU HEALTH MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 11/21/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 2605 E CREEKS EDGE DR
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City | BLOOMINGTON
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State | IN
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Zip | 47401-8368
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Country | US
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Telephone | 812-333-2663
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Fax |
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Provider Business Mailing Address
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Address Line | 2605 E CREEKS EDGE DR
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City | BLOOMINGTON
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State | IN
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Zip | 47401-8368
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Country | US
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Telephone | 812-333-2663
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | TODD A WILLIAMS
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Credential |
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Telephone | 317-709-4221
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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 |
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License Number State |
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