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General NPI Number Information
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NPI Number | 1922671312
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Entity Type | Organization
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Legal Business Name | DAMAR SERVICES INC.
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Dates
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Enumeration Date | 07/22/2021
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 5715 DECATUR BLVD
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City | INDIANAPOLIS
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State | IN
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Zip | 46241-9561
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Country | US
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Telephone | 317-455-2366
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Fax | 174-559-3513
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Provider Business Mailing Address
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Address Line | 6067 DECATUR BLVD
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City | INDIANAPOLIS
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State | IN
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Zip | 46241-9606
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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 | CEO
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Name | JIM L DALTON
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Credential |
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Telephone | 317-856-5201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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