Provider Demographics
NPI:1043460041
Name:INDIANA PERFUSION SERVICES, INC.
Entity Type:Organization
Organization Name:INDIANA PERFUSION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MERCHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-697-3141
Mailing Address - Street 1:1315 N ARLINGTON AVE
Mailing Address - Street 2:#220
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-3278
Mailing Address - Country:US
Mailing Address - Phone:317-353-2548
Mailing Address - Fax:
Practice Address - Street 1:1315 N ARLINGTON AVE
Practice Address - Street 2:#220
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-3278
Practice Address - Country:US
Practice Address - Phone:317-353-2548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty