Provider Demographics
NPI:1326023219
Name:AMERICAN HEALTH IMAGING OF INDIANA LLC
Entity Type:Organization
Organization Name:AMERICAN HEALTH IMAGING OF INDIANA LLC
Other - Org Name:INDIANAPOLIS HEALTH IMAGING SE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:ARANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-296-5887
Mailing Address - Street 1:1800 CENTURY BLVD NE
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3202
Mailing Address - Country:US
Mailing Address - Phone:404-296-5887
Mailing Address - Fax:
Practice Address - Street 1:7855 S EMERSON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8668
Practice Address - Country:US
Practice Address - Phone:317-888-1720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN217640Medicare PIN