Indiana Immunization Coalition Inc

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

INDIANA IMMUNIZATION COALITION INC

Practice address

6919 E 10TH St Ste C2
Indianapolis, IN 46219-4811

Phone

(317) 679-2309

Fax

(800) 285-1013

NPI assigned

Jun 1, 2020

Last updated

Mar 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa K Robertson, MPH

Title

Executive Director

Phone

(317) 679-2309

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1598389991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6919 E 10TH ST STE C2",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194811",
            "telephone_number": "317-679-2309",
            "fax_number": "800-285-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6919 E 10TH ST STE C2",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194811",
            "telephone_number": "317-679-2309",
            "fax_number": "800-285-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA IMMUNIZATION COALITION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-01",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "317-679-2309",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Indiana Hemophilia & Thrombosis Center, Inc.
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• Indiana Home Care Services LLC (Premier Homecare of Indiana)
• Indiana Home Health, Inc
• Indiana Immediate Care
• Indiana Integrated Services LLC
• Indiana Intellect Home Care LLC
• Indiana Interventional Pain, LLC
• Indiana Math and Science Academy
• Indiana Math and Science Academy - Central

• Public Health or Welfare Agency in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Public Health or Welfare Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.