Organization
MD2U INDIANA LLC
Active
Parent organization
MD2U MANAGEMENT LLC
Other names
MD2U The Leader In Medical House Calls
Organization subpart
Yes
Provider details
NPI number
Legal business name
MD2U MANAGEMENT LLC
Authorized official
GREGORY D LATTA (BUSINESS MANAGER)
(502) 327-9100
Entity
Organization
Contact information
Practice address
8888 KEYSTONE XING, SUITE 1300, INDIANAPOLIS, IN 46240-4609
(502) 327-9100
(855) 632-8329
Mailing address
PO BOX 7219, LOUISVILLE, KY 40257-0219
(502) 327-9100
(855) 632-8329
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15D2045574
CLIA - CERTIFICATE OF WAIVER
IN
Enumeration date
08/12/2010
Last updated
03/02/2015
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