Organization
CITIZENS HEALTH / BARTON ANNEX
Active
Organization
CITIZENS HEALTH / BARTON ANNEX
Active
Parent organization
CITIZENS HEALTH CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
CITIZENS HEALTH CORPORATION
Authorized official
MRS. JOLENE BURTRUM PHD (CHIEF EXECUTIVE OFFICER)
(317) 396-0280
Entity
Organization
Contact information
Practice address
501 N EAST ST, INDIANAPOLIS, IN 46204-1632
(317) 637-3449
(317) 927-3098
Mailing address
1650 N COLLEGE AVE, INDIANAPOLIS, IN 46202-1715
(317) 924-6351
(317) 927-3098
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100196020B
—
IN
Enumeration date
07/17/2009
Last updated
07/20/2009
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