Provider Demographics
NPI:1407873458
Name:HOOSIER ENTERPRISES III, INC.
Entity Type:Organization
Organization Name:HOOSIER ENTERPRISES III, INC.
Other - Org Name:TWIN CITY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-818-1240
Mailing Address - Street 1:9455 DELEGATES ROW
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3805
Mailing Address - Country:US
Mailing Address - Phone:317-818-1240
Mailing Address - Fax:317-818-1022
Practice Address - Street 1:627 E NORTH H ST
Practice Address - Street 2:
Practice Address - City:GAS CITY
Practice Address - State:IN
Practice Address - Zip Code:46933-1233
Practice Address - Country:US
Practice Address - Phone:765-674-8516
Practice Address - Fax:765-674-5075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
155232AMedicare ID - Type Unspecified