Provider Demographics
NPI:1780634964
Name:HEALTHNET, INC.
Entity Type:Organization
Organization Name:HEALTHNET, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-957-2000
Mailing Address - Street 1:3403 E RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-4744
Mailing Address - Country:US
Mailing Address - Phone:317-957-2000
Mailing Address - Fax:317-957-2050
Practice Address - Street 1:2855 N KEYSTONE AVE
Practice Address - Street 2:STE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-2790
Practice Address - Country:US
Practice Address - Phone:317-957-2300
Practice Address - Fax:317-957-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100117700Medicaid
IN151859Medicare PIN
IN151948Medicare PIN
IN151950Medicare PIN
IN151835Medicare PIN
IN1780634964Medicare Oscar/Certification
IN151852Medicare PIN
IN151853Medicare PIN
IN151888Medicare PIN
IN151920Medicare PIN
IN151925Medicare PIN
IN151953Medicare PIN
IN264420Medicare PIN
IN151854Medicare PIN
IN151856Medicare PIN
IN151902Medicare PIN
IN151938Medicare PIN
IN151945Medicare PIN
IN151836Medicare PIN
IN151917Medicare PIN
IN151918Medicare PIN
IN151944Medicare PIN
IN151967Medicare PIN
IN151875Medicare PIN
IN151886Medicare PIN
IN151887Medicare PIN
IN151916Medicare PIN
IN151889Medicare PIN
IN151804Medicare PIN