Provider Demographics
NPI:1629705553
Name:REHABILITATION INSTITUTE OF INDIANAPOLIS, INC.
Entity Type:Organization
Organization Name:REHABILITATION INSTITUTE OF INDIANAPOLIS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOFF
Authorized Official - Suffix:JR
Authorized Official - Credentials:CERT PROSTHETIST
Authorized Official - Phone:317-924-4505
Mailing Address - Street 1:2437 N MERIDIAN STREET
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208
Mailing Address - Country:US
Mailing Address - Phone:317-924-4505
Mailing Address - Fax:317-924-5223
Practice Address - Street 1:1200 S TILLOSTSON OVERPASS
Practice Address - Street 2:SUITE 3
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304
Practice Address - Country:US
Practice Address - Phone:317-924-4505
Practice Address - Fax:317-924-5223
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REHABILITATION INSTITUTE OF INDIANA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier