Organization
MIDWEST PROVIDER GROUP.DME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL K O'NEAL (PRESIDENT)
(317) 677-6572
Entity
Organization
Contact information
Practice address
1449 N PENNSYLVANIA ST, INDIANAPOLIS, IN 46202-2420
(317) 677-6572
Mailing address
1449 NORTH PENNSYLVANIA ST, INDIANAPOLIS, IN 46202
(317) 677-6572
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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