American Health Network of Indiana, LLC
Organization Active NPI Hematology & Oncology Physician · Avon, IN
NPI 1679677702 · NPPES record last updated May 20, 2009
Key facts
- NPI
- 1679677702
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- Legal business name
- AMERICAN HEALTH NETWORK OF INDIANA, LLC
- Practice address
- 1111 Ronald Reagan Pkwy
Suite 1600
Avon, IN 46123-7085 - Phone
- (317) 329-7430
- Fax
- (317) 329-7485
- NPI assigned
- Sep 11, 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031124000691 | IN | Part B Supplier - Clinic/Group Practice | 9830093533 |
Receives reassigned benefits from 230 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Part of
- American Health Network LLC
Locations
1111 Ronald Reagan Pkwy
Ste 1600
Avon, IN 46123
Phone (317) 329-7430
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician |
207RH0003X | Yes |
Addresses
Primary practice location
1111 Ronald Reagan Pkwy
Suite 1600
Avon, IN 46123-7085
Mailing address
6820 Parkdale PL
Suite 200
Indianapolis, IN 46254-6601
Phone (317) 329-7430
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100133190J | Medicaid | IN |
Other providers in Avon, IN
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
- American Health Network of Indiana, LLC
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- Anchor Pointe
All providers in Avon, IN · Hematology & Oncology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2009. 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.