Provider Demographics
NPI:1619267515
Name:VITAS HEALTHCARE CORPORATION MIDWEST
Entity Type:Organization
Organization Name:VITAS HEALTHCARE CORPORATION MIDWEST
Other - Org Name:VITAS INNOVATIVE HOSPICE OF GREATER INDIANAPOLIS
Other - Org Type:Other Name
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTFALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-374-4141
Mailing Address - Street 1:3046 CORPORATE WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6547
Mailing Address - Country:US
Mailing Address - Phone:786-350-5930
Mailing Address - Fax:
Practice Address - Street 1:3209 W SMITH VALLEY RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-8495
Practice Address - Country:US
Practice Address - Phone:305-350-6058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2018-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based