Provider Demographics
NPI:1891946430
Name:MICAH 68 CORPORATION
Entity Type:Organization
Organization Name:MICAH 68 CORPORATION
Other - Org Name:DIRECT LINK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:LINDGREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-888-8560
Mailing Address - Street 1:8333 FLICKER CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-9145
Mailing Address - Country:US
Mailing Address - Phone:317-888-8560
Mailing Address - Fax:317-888-4368
Practice Address - Street 1:8333 FLICKER CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-9145
Practice Address - Country:US
Practice Address - Phone:317-888-8560
Practice Address - Fax:317-888-4368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty