Provider Demographics
NPI:1710247234
Name:JSL ARCHIVAL SERVICES
Entity Type:Organization
Organization Name:JSL ARCHIVAL SERVICES
Other - Org Name:OFFICE 360
Other - Org Type:Other Name
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE
Authorized Official - Prefix:MS
Authorized Official - First Name:BARRI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SHIRK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BA
Authorized Official - Phone:317-803-9715
Mailing Address - Street 1:2002 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46225-2801
Mailing Address - Country:US
Mailing Address - Phone:317-803-9715
Mailing Address - Fax:317-454-8573
Practice Address - Street 1:2002 S EAST ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46225-2801
Practice Address - Country:US
Practice Address - Phone:317-803-9715
Practice Address - Fax:317-454-8573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201062660Medicaid