Provider Demographics
NPI:1831422989
Name:INDIANA SLEEP CENTER LLC
Entity type:Organization
Organization Name:INDIANA SLEEP CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BECKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-885-3787
Mailing Address - Street 1:701 E COUNTY LINE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1072
Mailing Address - Country:US
Mailing Address - Phone:317-887-6400
Mailing Address - Fax:317-887-6500
Practice Address - Street 1:701 E COUNTY LINE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1072
Practice Address - Country:US
Practice Address - Phone:317-887-6400
Practice Address - Fax:317-887-6500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036623A261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01067876AOtherMEDICAL DIRECTOR LICENSE NUMBER