Provider Demographics
NPI:1144395427
Name:CLARIAN HEALTH - I.U. HOSPITAL
Entity Type:Organization
Organization Name:CLARIAN HEALTH - I.U. HOSPITAL
Other - Org Name:CLARIAN HEALTH - I.U. DME
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:B
Authorized Official - Last Name:RADABAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-962-4600
Mailing Address - Street 1:950 N MERIDIAN ST
Mailing Address - Street 2:ATTENTION-JEFFREY B. RADABAUGH, SUITE 700
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1077
Mailing Address - Country:US
Mailing Address - Phone:317-962-4600
Mailing Address - Fax:317-962-4646
Practice Address - Street 1:550 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5149
Practice Address - Country:US
Practice Address - Phone:317-962-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLARIAN HEALTH PARTNERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-21
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200285760AMedicaid
IN1133670017Medicare ID - Type Unspecified