MEDICARE: LIFE SOLUTIONS SOUTH OF INDIANA

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	305R00000X	Preferred Provider Organization

General Provider Information

NPI Number	:	1679965263
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE SOLUTIONS SOUTH OF INDIANA

Provider Business Mailing Address
First Line	:	120 E MARKET ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-3250
Country	:	US
Telephone Number	:	919-492-0783
Fax Number	:	800-901-0720

Provider Business Practice Location Address
First Line	:	120 E MARKET ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-3250
Country	:	US
Telephone Number	:	919-492-0783
Fax Number	:	800-901-0720

Authorized Official
Title or Position	:	HUMAN RESOURCES
Name	:	MRS. GIA HOPKINS
Credential	:
Telephone Number	:	919-492-0783

Provider Enumeration Date	:	02/19/2015
Last Update Date	:	02/19/2015

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Directions to “LIFE SOLUTIONS SOUTH OF INDIANA ” Practice Location

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