Organization
INDIANA BLOOD AND MARROW TRANSPLANTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA PHALEN (DIRECTOR REV INTEGRITY)
(219) 554-4548
Entity
Organization
Contact information
Practice address
8111 S EMERSON AVE, SUITE 105, INDIANAPOLIS, IN 46237-8601
(317) 528-5500
(317) 528-7356
Mailing address
PO BOX 781090, DETROIT, MI 48278-1090
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100131340
—
IN
Enumeration date
08/18/2006
Last updated
09/19/2023
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