Provider Demographics
NPI:1770864985
Name:INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERFIEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-751-2795
Mailing Address - Street 1:5000 W PRAIRIEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-3485
Mailing Address - Country:US
Mailing Address - Phone:765-284-3072
Mailing Address - Fax:
Practice Address - Street 1:5000 W PRAIRIEWOOD DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-3485
Practice Address - Country:US
Practice Address - Phone:765-284-3072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003655A363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty