Organization
INDIANA HEALTH COVERAGE PROGRAM
Active
Parent organization
423-25-6682
Organization subpart
Yes
Provider details
NPI number
Legal business name
423-25-6682
Authorized official
MRS. LORIE W DAVIS (HEALTH ANALYST)
(317) 488-5000
Entity
Organization
Contact information
Practice address
950 N MERIDIAN ST, SUITE 1150, INDIANAPOLIS, IN 46204-4288
(317) 488-5000
Mailing address
950 N MERIDIAN ST, SUITE 1150, INDIANAPOLIS, IN 46204-4288
(317) 488-5000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/16/2013
Last updated
11/16/2013
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