Provider Demographics
NPI:1487858205
Name:CVILLE DOCS INC
Entity Type:Organization
Organization Name:CVILLE DOCS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:L
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-634-6971
Mailing Address - Street 1:1408 DARLINGTON AVE
Mailing Address - Street 2:STE. F
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-2056
Mailing Address - Country:US
Mailing Address - Phone:765-364-6971
Mailing Address - Fax:765-364-6976
Practice Address - Street 1:1408 DARLINGTON AVE
Practice Address - Street 2:STE. F
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-2056
Practice Address - Country:US
Practice Address - Phone:765-364-6971
Practice Address - Fax:765-364-6976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200867870AMedicaid
IN200867870AMedicaid