Provider Demographics
NPI:1164866844
Name:ORGANIC HEALTH SERVICES
Entity Type:Organization
Organization Name:ORGANIC HEALTH SERVICES
Other - Org Name:INDIANA REPRODUCTIVE ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:YOURAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:317-846-8777
Mailing Address - Street 1:12188 N. MERIDIAN A
Mailing Address - Street 2:SUITE 225
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:317-846-8777
Mailing Address - Fax:317-846-8834
Practice Address - Street 1:12188A N MERIDIAN ST
Practice Address - Street 2:SUITE 225
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4406
Practice Address - Country:US
Practice Address - Phone:317-846-8777
Practice Address - Fax:317-846-8834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN84000066A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty