Provider Demographics
NPI:1316182728
Name:INDIMED CORPORATION INC
Entity Type:Organization
Organization Name:INDIMED CORPORATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:W
Authorized Official - Last Name:MARCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-658-1326
Mailing Address - Street 1:8605 ALLISONVILLE RD
Mailing Address - Street 2:SUITE 253
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1552
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8605 ALLISONVILLE RD
Practice Address - Street 2:SUITE 253
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1552
Practice Address - Country:US
Practice Address - Phone:317-658-1326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038745207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN259070Medicare PIN