Provider Demographics
NPI:1144226143
Name:REHABILITATION INSTITUTE OF INDIANAPOLIS INC.
Entity Type:Organization
Organization Name:REHABILITATION INSTITUTE OF INDIANAPOLIS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOFF
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:317-924-4505
Mailing Address - Street 1:2437 N MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-5731
Mailing Address - Country:US
Mailing Address - Phone:317-924-4505
Mailing Address - Fax:866-724-5223
Practice Address - Street 1:2437 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-5731
Practice Address - Country:US
Practice Address - Phone:317-924-4505
Practice Address - Fax:317-924-5223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000097377OtherANTHEM BC/BS
INRE524070OtherCHILDRENS SPECIAL HEALTH
IN100177080AMedicaid
IN100177080AMedicaid