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Organization

CHARTWELL MIDWEST INDIANA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHARI LYNN PENTICUFF RN (GENERAL MANAGER)
(317) 594-3333
Entity
Organization

Contact information

Practice address
8040 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1943
(317) 594-3333
(317) 594-3330
Mailing address
4190 RELIABLE PKWY, CHICAGO, IL 60684-0001
(317) 594-3333
(317) 594-3330

Taxonomy

Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
IN
332B00000X
Durable Medical Equipment & Medical Supplies
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
60005571A
IN
3336H0001X
Home Infusion Therapy Pharmacy
60005571A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1598761074
RENDERING PIN
IN
Enumeration date
06/21/2005
Last updated
01/07/2008
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