Provider Demographics
NPI:1376849851
Name:SYNCARE,LLC
Entity Type:Organization
Organization Name:SYNCARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MISS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-496-3552
Mailing Address - Street 1:8777 PURDUE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3125
Mailing Address - Country:US
Mailing Address - Phone:317-496-3552
Mailing Address - Fax:317-755-4012
Practice Address - Street 1:8777 PURDUE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-3125
Practice Address - Country:US
Practice Address - Phone:317-496-3552
Practice Address - Fax:317-755-4012
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SYNCARE,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN200267290A251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200819080AMedicaid