Provider Demographics
NPI:1558491894
Name:INDIANA WESLEYAN UNIVERSITY
Entity Type:Organization
Organization Name:INDIANA WESLEYAN UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH CENTER DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:AARON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-677-2486
Mailing Address - Street 1:4201 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-4974
Mailing Address - Country:US
Mailing Address - Phone:765-677-2206
Mailing Address - Fax:765-677-2849
Practice Address - Street 1:4201 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-4974
Practice Address - Country:US
Practice Address - Phone:765-677-2206
Practice Address - Fax:765-677-2849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health