East Central Indiana Vascular Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

EAST CENTRAL INDIANA VASCULAR LAB LLC

Practice address

1812 W Royale Dr
Muncie, IN 47304-2243

Phone

(765) 284-7703

Fax

(765) 284-6838

NPI assigned

Jul 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Eliades, M.D.

Title

Director

Phone

(765) 284-7703

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patrick A Cleary, MD, PH.D.

  • Surgery Physician
  • Muncie, IN
  • NPI 1508831538
  NPD (past)
• Alex M Cocco, MD

  • Surgery Physician
  • Muncie, IN
  • NPI 1376519173
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1245252592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 W ROYALE DR",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042243",
            "telephone_number": "765-284-7703",
            "fax_number": "765-284-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 W ROYALE DR",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042243",
            "telephone_number": "765-284-7703",
            "fax_number": "765-284-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CENTRAL INDIANA VASCULAR LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ELIADES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "765-284-7703",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201040080",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alice Dyson, CCC/SLP
• Elizabeth Joan Earl
• East Central Indiana Oral and Maxillofacial Surgery, LLC
• East Central Indiana Pathologists PC
• East Central Indiana Primary Care Network
• East Central Radiology
• Eastern Indiana Neurology, P.C.
• Matthew A Eaton, DO
• Ec Muncie Operations, LLC
• Ec Opco Muncie, LLC

• Clinical Medical Laboratory in Muncie, IN
• Providers in Muncie, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.