MEDICARE: VERSITI BLOOD HEALTH 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
1	331L00000X	Blood Bank	070059311	IN

General Provider Information

NPI Number	:	1538296140
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERSITI BLOOD HEALTH INC.

Provider Business Mailing Address
First Line	:	3450 N MERIDIAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-4437
Country	:	US
Telephone Number	:	317-916-5000
Fax Number	:	317-916-5005

Provider Business Practice Location Address
First Line	:	3450 N MERIDIAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-4437
Country	:	US
Telephone Number	:	317-916-5000
Fax Number	:	317-916-5005

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER EXEC VP
Name	:	DR. DAN ALLEN WAXMAN
Credential	:	M.D.
Telephone Number	:	317-916-5008

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	01/29/2026

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