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NPI Code Detail

MEDICARE: BIO-MEDICAL APPLICATIONS OF INDIANA, INC.

MEDICARE: BIO-MEDICAL APPLICATIONS OF INDIANA, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1396762035
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIO-MEDICAL APPLICATIONS OF INDIANA, INC.
Provider Business Mailing Address
First Line : 1708 CRAGMONT ST
Second Line :
City : MADISON
State : IN
Zip : 47250-2808
Country : US
Telephone Number : 812-273-7131
Fax Number : 812-273-7135
Provider Business Practice Location Address
First Line : 1708 CRAGMONT ST
Second Line :
City : MADISON
State : IN
Zip : 47250-2808
Country : US
Telephone Number : 812-273-7131
Fax Number : 812-273-7135
Authorized Official
Title or Position : TREASURER
Name : MARK FAWCETT
Credential :
Telephone Number : 800-662-1237
Provider Enumeration Date : 07/17/2006
Last Update Date : 06/18/2008

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