Provider Demographics
NPI:1184835654
Name:AMERICAN HEALTH NETWORK OF INDIANA, LLC
Entity Type:Organization
Organization Name:AMERICAN HEALTH NETWORK OF INDIANA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENENE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-735-7502
Mailing Address - Street 1:9002 N MERIDIAN ST
Mailing Address - Street 2:STE 214
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5381
Mailing Address - Country:US
Mailing Address - Phone:317-927-5770
Mailing Address - Fax:317-927-5792
Practice Address - Street 1:6925 SHORE TER
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-4675
Practice Address - Country:US
Practice Address - Phone:317-927-5770
Practice Address - Fax:317-927-5972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN224290Medicare ID - Type Unspecified