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	291U00000X	Clinical Medical Laboratory	74465305	IN

General Provider Information

NPI Number	:	1568699122
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	:	414-937-6387
Fax Number	:

Provider Business Practice Location Address
First Line	:	3450 N MERIDIAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-4437
Country	:	US
Telephone Number	:	317-916-5237
Fax Number	:

Authorized Official
Title or Position	:	CONTROLLER
Name	:	DAWN HENSE
Credential	:
Telephone Number	:	414-937-6387

Provider Enumeration Date	:	06/22/2009
Last Update Date	:	05/28/2026

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