UNITY HEALTHCARE, LLC

Provider Demographics

• NPI: 1619929098
• Name: UNITY HEALTHCARE, LLC
• Entity Type: Organization
• Organization Name: UNITY HEALTHCARE, LLC
• Authorized Official - Title/Position: DIRECTOR OF BILLING
• Authorized Official - First Name: MARTHA
• Authorized Official - Middle Name: K
• Authorized Official - Last Name: MILLER
• Authorized Official - Phone: 765-446-5286
• Mailing Address - Street 1: PO BOX 4699
• Mailing Address - City: LAFAYETTE
• Mailing Address - State: IN
• Mailing Address - Zip Code: 47903-4699
• Mailing Address - Country: US
• Mailing Address - Phone: 765-446-5417
• Mailing Address - Fax: 765-446-5317
• Practice Address - Street 1: 1250 S CREASY LN
• Practice Address - Street 2: SUITE A
• Practice Address - City: LAFAYETTE
• Practice Address - State: IN
• Practice Address - Zip Code: 47905-4960
• Practice Address - Country: US
• Practice Address - Phone: 765-446-5417
• Practice Address - Fax: 765-446-5317
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-05-16
• Last Update Date: 2019-08-16

Provider Licenses

State	License ID	Taxonomies
IN	207K00000X	207K00000X
IN	207Z00000X	207Q00000X
IN	207R00000X	207R00000X
IN	207V00000X	207V00000X
IN	207VG0400X	207VG0400X
IN	207W0000X	207W00000X
IN	207Y00000X	207Y00000X
IN	207YS0123X	207YS0123X
IN	208000000X	208000000X
IN	208200000X	208200000X
IN	2085R0001X	2085R0001X
IN	2085R0202X	2085R0202X
IN	208800000X	208800000X
		261Q00000X
IN	363L00000X	363L00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	261Q00000X	Ambulatory Health Care Facilities	Clinic/Center		Group - Multi-Specialty
No	207K00000X	Allopathic & Osteopathic Physicians	Allergy & Immunology		Group - Multi-Specialty
No	207Q00000X	Allopathic & Osteopathic Physicians	Family Medicine		Group - Multi-Specialty
No	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine		Group - Multi-Specialty
No	207V00000X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology		Group - Multi-Specialty
No	207VG0400X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology	Gynecology	Group - Multi-Specialty
No	207W00000X	Allopathic & Osteopathic Physicians	Ophthalmology		Group - Multi-Specialty
No	207Y00000X	Allopathic & Osteopathic Physicians	Otolaryngology		Group - Multi-Specialty
No	207YS0123X	Allopathic & Osteopathic Physicians	Otolaryngology	Facial Plastic Surgery	Group - Multi-Specialty
No	208000000X	Allopathic & Osteopathic Physicians	Pediatrics		Group - Multi-Specialty
No	208200000X	Allopathic & Osteopathic Physicians	Plastic Surgery		Group - Multi-Specialty
No	2085R0001X	Allopathic & Osteopathic Physicians	Radiology	Radiation Oncology	Group - Multi-Specialty
No	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology	Group - Multi-Specialty
No	208800000X	Allopathic & Osteopathic Physicians	Urology		Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
IN	CD6272	Other	RAILROAD MEDICARE
IN	815170	Medicare PIN
IN	210800	Medicare PIN
IN	815160	Medicare PIN
IN	815010	Medicare PIN
IN	193290	Medicare PIN
IN	ZL2070	Medicare PIN
IN	815150	Medicare PIN
IN	815140	Medicare PIN