Provider Demographics
NPI:1336550383
Name:VERVE HEALTH LLC
Entity Type:Organization
Organization Name:VERVE HEALTH LLC
Other - Org Name:VERVE HEALTH AT CELADON CORPORATE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ERB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-573-7600
Mailing Address - Street 1:8200 HAVERSTICK RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-4308
Mailing Address - Country:US
Mailing Address - Phone:317-573-7600
Mailing Address - Fax:
Practice Address - Street 1:9503 E 33RD ST
Practice Address - Street 2:MEDICAL CLINIC
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-4207
Practice Address - Country:US
Practice Address - Phone:317-972-7000
Practice Address - Fax:317-972-7088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002977A261QP2300X, 261QX0100X, 332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine