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NPI Code Detail

MEDICARE: BETWEEN THE CHEEKS, PC

MEDICARE: BETWEEN THE CHEEKS, PC
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
1183500000XPharmacist26019790AIN
2122300000XDentist12010288AIN

General Provider Information

NPI Number : 1598910598
Entity Type Code : Organization
Provider Name (Legal Business Name) : BETWEEN THE CHEEKS, PC
Provider Business Mailing Address
First Line : 5470 LAFAYETTE RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46254-1620
Country : US
Telephone Number : 317-293-4611
Fax Number : 317-297-7504
Provider Business Practice Location Address
First Line : 5470 LAFAYETTE RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46254-1620
Country : US
Telephone Number : 317-293-4611
Fax Number : 317-297-7504
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : MR. DAVID WESLEY MILLER
Credential : R.PH.
Telephone Number : 317-293-4611
Provider Enumeration Date : 11/19/2008
Last Update Date : 11/19/2008

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Directions to “BETWEEN THE CHEEKS, PC ” Practice Location

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