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General NPI Number Information
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NPI Number | 1902429251
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Entity Type | Organization
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Legal Business Name | TELACARE HEALTH SOLUTIONS, LLC
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Dates
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Enumeration Date | 05/21/2020
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 11650 OLIO RD STE 1000-172
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City | FISHERS
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State | IN
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Zip | 46037-7619
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Country | US
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Telephone | 800-317-0280
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Fax |
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Provider Business Mailing Address
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Address Line | 11650 OLIO RD STE 1000-172
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City | FISHERS
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State | IN
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Zip | 46037-7619
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Country | US
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Telephone | 800-317-0280
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LARRY DEAN JONES JR.
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Credential |
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Telephone | 800-317-0280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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