MEDICARE: PLANNED PARENTHOOD OF INDIANA BEDFORD

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	261QF0050X	Non-Surgical Family Planning Clinic/Center	01041899A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649529447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANNED PARENTHOOD OF INDIANA BEDFORD

Provider Business Mailing Address
First Line	:	200 S. MERIDIAN ST.
Second Line	:	SUITE 400
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46225
Country	:	US
Telephone Number	:	317-637-4343
Fax Number	:	317-637-4344

Provider Business Practice Location Address
First Line	:	717 LINCOLN AVE, #G
Second Line	:
City	:	BEDFORD
State	:	IN
Zip	:	47421-2145
Country	:	US
Telephone Number	:	812-279-3527
Fax Number	:	812-279-3528

Authorized Official
Title or Position	:	VICE PRESIDENT, FINANCE & ADMINISTR
Name	:	MS. SUZANNAH WILSON OVERHOLT
Credential	:	J.D.
Telephone Number	:	317-637-4166

Provider Enumeration Date	:	09/07/2012
Last Update Date	:	09/07/2012

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Directions to “PLANNED PARENTHOOD OF INDIANA BEDFORD ” Practice Location

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