Provider Demographics
NPI:1710427307
Name:PMR HEALTHCARE
Entity Type:Organization
Organization Name:PMR HEALTHCARE
Other - Org Name:PMR HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:DONADIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-882-1232
Mailing Address - Street 1:7399 N SHADELAND AVE
Mailing Address - Street 2:#103
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2052
Mailing Address - Country:US
Mailing Address - Phone:317-845-5974
Mailing Address - Fax:317-845-5975
Practice Address - Street 1:10500 ODAY HARRISON RD
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:OH
Practice Address - Zip Code:43143-9474
Practice Address - Country:US
Practice Address - Phone:317-845-5974
Practice Address - Fax:317-845-5975
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER MEDICAL RESOURCES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-01
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care