Provider Demographics
NPI:1669991279
Name:INDIANA UNIVERSITY HEALTH JAY, INC.
Entity type:Organization
Organization Name:INDIANA UNIVERSITY HEALTH JAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VANATOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-741-2891
Mailing Address - Street 1:950 N MERIDIAN ST STE 1200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 W VOTAW ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:IN
Practice Address - Zip Code:47371-1322
Practice Address - Country:US
Practice Address - Phone:260-726-7131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INDIANA UNIVERSITY HEALTH JAY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-14
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit