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Organization
MAJOR HOSPITAL
Active
Organization
MAJOR HOSPITAL
Active
Other names
The Waters of Indianapolis
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HORNER (PRESIDENT & CEO)
(317) 398-5252
Entity
Organization
Contact information
Practice address
3895 S KEYSTONE AVE, INDIANAPOLIS, IN 46227-3540
(317) 787-5364
(317) 788-3962
Mailing address
3895 S KEYSTONE AVE, INDIANAPOLIS, IN 46227-3540
(317) 787-5364
(765) 788-3960
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05-000537-3
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381427
ANTHEM BCBS
IN
01
—
000000476407
ANTHEM OT
IN
01
—
000000476408
ANTHEM PT
IN
01
—
000000476409
ANTHEM ST
IN
05
—
100267270C
—
IN
01
—
5585000001
DMERC REGION B SUPPLIER#
IN
Enumeration date
06/04/2006
Last updated
08/07/2014
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