Organization
TRU ARCH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN K KIDWELL C PED (PRESIDENT)
(812) 232-0910
Entity
Organization
Contact information
Practice address
2307 S 3RD ST, TERRE HAUTE, IN 47802
(812) 232-0910
(812) 232-0936
Mailing address
2307 S 3RD ST, TERRE HAUTE, IN 47802-3048
(812) 232-0910
(812) 232-0936
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000318389
ANTHEM
IL
05
—
200464020A
—
IN
Enumeration date
09/28/2006
Last updated
06/27/2023
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