Provider Demographics
NPI:1841710928
Name:INDIANA NEIGHBORHOOD HOSPITAL, LLC
Entity type:Organization
Organization Name:INDIANA NEIGHBORHOOD HOSPITAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-338-7074
Mailing Address - Street 1:250 WEST 96TH STREET
Mailing Address - Street 2:SUITE 400
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1316
Mailing Address - Country:US
Mailing Address - Phone:317-338-2432
Mailing Address - Fax:317-338-6960
Practice Address - Street 1:9613 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7978
Practice Address - Country:US
Practice Address - Phone:317-613-5300
Practice Address - Fax:317-338-6960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty