Provider Demographics
NPI:1376814608
Name:TOTAL IMAGE SYSTEMS OF INDIANA INC
Entity Type:Organization
Organization Name:TOTAL IMAGE SYSTEMS OF INDIANA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BARNEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-304-6454
Mailing Address - Street 1:405 RAINBOW CIR
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-3632
Mailing Address - Country:US
Mailing Address - Phone:765-244-0342
Mailing Address - Fax:
Practice Address - Street 1:405 RAINBOW CIR
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3632
Practice Address - Country:US
Practice Address - Phone:765-244-0342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health