Provider Demographics
NPI:1518094994
Name:STATE OF INDIANA AUDITOR OF ST
Entity Type:Organization
Organization Name:STATE OF INDIANA AUDITOR OF ST
Other - Org Name:INDIANA SCHOOL FOR THE BLIND AND VISUALLY IMPAIRED
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-253-1481
Mailing Address - Street 1:7725 N COLLEGE AVENUE
Mailing Address - Street 2:INDIANA SCHOOL FOR THE BLIND
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240
Mailing Address - Country:US
Mailing Address - Phone:317-253-1481
Mailing Address - Fax:317-251-6511
Practice Address - Street 1:7725 N COLLEGE AVENUE
Practice Address - Street 2:INDIANA SCHOOL FOR THE BLIND
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240
Practice Address - Country:US
Practice Address - Phone:317-253-1481
Practice Address - Fax:317-251-6511
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF INDIANA AUDITOR OF STATE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-27
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200093290AMedicaid