Provider Demographics
NPI:1477138709
Name:CHOICE MEDICAL INSTITUTE
Entity Type:Organization
Organization Name:CHOICE MEDICAL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:317-778-2826
Mailing Address - Street 1:12995 STAR DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-5982
Mailing Address - Country:US
Mailing Address - Phone:317-778-2826
Mailing Address - Fax:
Practice Address - Street 1:8149 E 30TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-1342
Practice Address - Country:US
Practice Address - Phone:317-778-2826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No251300000XAgenciesLocal Education Agency (LEA)