Organization
VISIONARY ENTERPRISES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE HOGAN (SVP)
(317) 621-7409
Entity
Organization
Contact information
Practice address
7120 CLEARVISTA DR STE 1000, ATTN: FIGLEAF BOUTIQUE, INDIANAPOLIS, IN 46256-1672
(317) 621-5323
(317) 621-3447
Mailing address
6626 E 75TH ST STE 200, ATTN L PENDLETON, INDIANAPOLIS, IN 46250-2855
(317) 621-7543
(317) 621-7163
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000695887
ANTHEM
IN
05
—
201011550A
—
IN
Enumeration date
06/26/2007
Last updated
07/30/2019
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