Organization
ICEM-BALL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL KARP (CHIEF FINANCIAL OFFICER)
(317) 278-9909
Entity
Organization
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-3241
Mailing address
950 N MERIDIAN ST, SUITE 500, INDIANAPOLIS, IN 46204-1077
(317) 962-1775
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200977750A
—
IN
01
—
DQ3173
RAILROAD MEDICARE
IN
Enumeration date
10/21/2009
Last updated
03/16/2011
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