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Organization
INDIANA HEART HOSPITAL, LLC
Active
Organization
INDIANA HEART HOSPITAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY GAMACHE (CHIEF FINANCIAL OFFICER)
(317) 621-8057
Entity
Organization
Contact information
Practice address
8075 N SHADELAND AVE, INDIANAPOLIS, IN 46250-2693
(317) 621-8000
(317) 621-8111
Mailing address
6233 RELIABLE PKWY, CHICAGO, IL 60686-0062
(317) 621-8000
(317) 621-8111
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
003312
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000020325
M PLAN PROVIDER NUMBER
—
01
—
000000251112
ANTHEM PROVIDER NUMBER
—
05
—
200400370A
—
IN
05
—
200484840A
—
IN
01
—
23783HH
HEALTHMARK PROVIDER NUMBE
—
01
—
7786435
AETNA PROVIDER NUMBER
—
Enumeration date
01/19/2006
Last updated
03/28/2013
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