Provider Demographics
NPI:1164852513
Name:THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Entity Type:Organization
Organization Name:THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Other - Org Name:ESKENAZI HEALTH CENTER PEDIATRIC URGENT CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUXSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-880-5101
Mailing Address - Street 1:PO BOX 637951
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7951
Mailing Address - Country:US
Mailing Address - Phone:317-880-4055
Mailing Address - Fax:
Practice Address - Street 1:720 ESKENAZI AVE
Practice Address - Street 2:ESKENAZI HEALTH OUTPATIENT CARE CENTER, 2ND FLOOR
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5166
Practice Address - Country:US
Practice Address - Phone:317-880-7666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-21
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)