# INDIANA IMMUNIZATION COALITION INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598389991
- **Authorized official:** MRS. LISA K ROBERTSON MPH (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (317) 679-2309

## Contact information

- **Practice address:** 6919 E 10TH ST STE C2, INDIANAPOLIS, IN 46219-4811
- **Practice address phone:** (317) 679-2309
- **Practice address fax:** (800) 285-1013
- **Mailing address:** 6919 E 10TH ST STE C2, INDIANAPOLIS, IN 46219-4811
- **Mailing address phone:** (317) 679-2309
- **Mailing address fax:** (800) 285-1013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/01/2020
- **Last updated:** 03/21/2024