Meridian Health Services Corp
Organization Active NPI Substance Abuse Rehabilitation Facility · Richmond, IN
NPI 1508300161 · NPPES record last updated Dec 15, 2016
Key facts
- NPI
- 1508300161
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- Legal business name
- MERIDIAN HEALTH SERVICES CORP
- Practice address
- 498 NW 18TH St
Suite a
Richmond, IN 47374-2851 - Phone
- (765) 288-1928
- Fax
- (765) 741-0335
- NPI assigned
- Dec 15, 2016
- Organization subpart
- No
Authorized official
- Name
- Kirk Shafer
- Title
- Cfo, VP
- Phone
- (765) 288-1928
Other NPIs on the same Medicare enrollment 48
Corporate family (same tax ID) 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031119000531 | IN | Part B Supplier - Clinic/Group Practice | 5597679845 |
Receives reassigned benefits from 319 practitioners 48 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Comprehensive Mental HLTH
Locations
498 NW 18th St
Ste A
Richmond, IN 47374
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | Yes |
Addresses
Primary practice location
498 NW 18TH St
Suite a
Richmond, IN 47374-2851
Mailing address
240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928
Other names
- Residential Substance Abuse Treatment Program
NPI Registry JSON
{
"created_epoch": "1481760000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1481760000000",
"number": "1508300161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 N TILLOTSON AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473043988",
"telephone_number": "765-288-1928",
"fax_number": "765-741-0335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "498 NW 18TH ST",
"address_2": "SUITE A",
"city": "RICHMOND",
"state": "IN",
"postal_code": "473742851",
"telephone_number": "765-288-1928",
"fax_number": "765-741-0335"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MERIDIAN HEALTH SERVICES CORP",
"organizational_subpart": "NO",
"enumeration_date": "2016-12-15",
"last_updated": "2016-12-15",
"status": "A",
"authorized_official_last_name": "SHAFER",
"authorized_official_first_name": "KIRK",
"authorized_official_title_or_position": "CFO, VP",
"authorized_official_telephone_number": "765-288-1928"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Residential Substance Abuse Treatment Program",
"code": "5",
"type": "Other Name"
}
]
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All providers in Richmond, IN · Substance Abuse Rehabilitation Facility in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.