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American Health Network of Indiana, LLC

Organization Active NPI Durable Medical Equipment & Medical Supplies · Avon, IN

NPI 1417044454 · NPPES record last updated Apr 9, 2020

Key facts

NPI
1417044454
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
AMERICAN HEALTH NETWORK OF INDIANA, LLC
Practice address
8607 E US Highway 36 Ste 100
Avon, IN 46123-7960
Phone
(317) 745-5403
Fax
(317) 745-8017
NPI assigned
Oct 10, 2006
Organization subpart
Yes
Parent organization (as reported)
AMERICAN HEALTH NETWORK OF INDIANA, LLC

Authorized official

Name
Ben H Park, MD
Title
President and Ceo
Phone
(317) 580-6307

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 206

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

View all 206

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0352644American Health Network of Indiana, LLC
8607 E US Hwy 36, Avon, IN 46123		Certificate of waiverFeb 4, 2027
15D2105378American Health Network of in, LLC
8607 East US Highway 36, Ste 300, Avon, IN 46123		Certificate of waiverNov 23, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Physicians Medical Center LLC
New Albany, IN · CCN 150172		 Hospital 5% Or Greater Indirect Ownership Interest (26.71%) Dec 14, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930065220 IN DME Supplier - Physician - Podiatry
DME Supplier - Physician - Orthopedic/Orthopedic Surgery		 9830093533 Practice locations: Avon, IN

National Provider Directory

Tax ID family
American Health Network LLC (33 organizations share this tax ID)
Part of
American Health Network LLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

8607 E US Highway 36 Ste 100
Avon, IN 46123-7960

Mailing address

8607 E US Highway 36 Ste 100
Avon, IN 46123-7960
Phone (317) 745-5403

Other providers in Avon, IN

All providers in Avon, IN · Durable Medical Equipment & Medical Supplies in Indiana

Sources for this page

Verify at the official NPI Registry.