Organization
INDIANA MOTHERS' MILK BANK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANE NUTTY (PROGRAM COORDINATOR)
(317) 329-7146
Entity
Organization
Contact information
Practice address
6820 PARKDALE PL, SUITE 109, INDIANAPOLIS, IN 46254-6601
(317) 329-7146
(317) 329-7151
Mailing address
6820 PARKDALE PL, SUITE 109, INDIANAPOLIS, IN 46254-6601
(317) 329-7146
(317) 329-7151
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Enumeration date
10/25/2007
Last updated
04/20/2008
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