Organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Active
Parent organization
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Authorized official
BEN H PARK MD (PRESIDENT AND CEO)
(317) 580-6307
Entity
Organization
Contact information
Practice address
55 BRENDON WAY, SUITE 100, ZIONSVILLE, IN 46077-1961
(317) 873-6700
(317) 873-8200
Mailing address
4850 CENTURY PLAZA RD, SUITE 180, INDIANAPOLIS, IN 46254-5476
(317) 873-6700
(317) 873-8200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0828280018
DMERC
IN
05
—
100216850E
—
IN
Enumeration date
08/17/2006
Last updated
06/22/2017
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