Provider Demographics
NPI:1669550588
Name:HEART PARTNERS OF INDIANA LLC
Entity type:Organization
Organization Name:HEART PARTNERS OF INDIANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-863-5824
Mailing Address - Street 1:7321 SHADELAND STA STE 100
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3976
Mailing Address - Country:US
Mailing Address - Phone:317-863-5824
Mailing Address - Fax:317-841-0394
Practice Address - Street 1:8075 N SHADELAND
Practice Address - Street 2:#350
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250
Practice Address - Country:US
Practice Address - Phone:317-863-6000
Practice Address - Fax:317-841-0394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200044570Medicaid
IN200044570Medicaid