Provider Demographics
NPI:1346218799
Name:INDIANA UNIVERSITY HEALTH BEDFORD, INC.
Entity Type:Organization
Organization Name:INDIANA UNIVERSITY HEALTH BEDFORD, INC.
Other - Org Name:IU HEALTH BEDFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRADFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:DYKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-275-1200
Mailing Address - Street 1:2900 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-3510
Mailing Address - Country:US
Mailing Address - Phone:812-275-1200
Mailing Address - Fax:812-275-1370
Practice Address - Street 1:2900 16TH ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-3510
Practice Address - Country:US
Practice Address - Phone:812-275-1200
Practice Address - Fax:812-275-1370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN237402323OtherCOMMERCIAL
IN200033230AMedicaid
IN000000097631OtherANTHEM PROV.
IN200033230AMedicaid