Provider Demographics
NPI:1114394897
Name:MEDICAL SPECIALTY LLC
Entity Type:Organization
Organization Name:MEDICAL SPECIALTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBASPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:317-842-5771
Mailing Address - Street 1:7320 E 82ND ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1458
Mailing Address - Country:US
Mailing Address - Phone:317-842-5771
Mailing Address - Fax:317-576-1394
Practice Address - Street 1:2305 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-5729
Practice Address - Country:US
Practice Address - Phone:317-842-5771
Practice Address - Fax:317-576-1394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies