NPIMap

Organization Active NPI

Indiana University Health Ball Memorial Hospital Inc

  • Community/Retail Pharmacy
  • Yorktown, IN
National Provider Identifier
1720182777
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
60004901A Issued in IN
Legal business name
INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL INC
Practice address
1420 S Pilgrim Blvd
Yorktown, IN 47396-9250
Phone
(765) 759-4064
Fax
(765) 759-4073
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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

Authorized official

Name
Lori Luther
Title
Cfo
Phone
(765) 751-2795

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 60004901A IN Primary

Addresses

Primary practice location

1420 S Pilgrim Blvd
Yorktown, IN 47396-9250

Mailing address

1633 N Capitol Ave
Suite 438
Indianapolis, IN 46202-1261
Phone (317) 963-9730

Other identifiers 2

IdentifierTypeStateIssuer
200098740MedicaidIN
1532717OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • IU Health Yorktown Pharmacy Doing business as

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 6

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

Practitioners 3

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

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Indiana Uni HLTH Ball Mem Hosp Inc1420 S Pilgrim Blvd, Yorktown, IN 47396-9250(765) 759-4064 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Jan 1, 1998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111121001014 IN DME Supplier - Pharmacy 5698688273 Practice locations: Yorktown, IN
O20130124000278 IN Part B Supplier - Mass Immunization (Roster Biller Only) 5698688273 9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yorktown, IN; Muncie, IN; Hartford City, IN

National Provider Directory

National Provider Directory
Tax ID family
Indiana University HLTH Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Member of 2

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

Locations

1385 N Baldwin Ave
Marion, IN 46952
Phone (765) 671-7900

1500 Neeley Ave
Muncie, IN 47306
Phone (765) 285-1079

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1720182777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 N CAPITOL AVE",
            "address_2": "SUITE 438",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021261",
            "telephone_number": "317-963-9730",
            "fax_number": "317-963-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S PILGRIM BLVD",
            "city": "YORKTOWN",
            "state": "IN",
            "postal_code": "473969250",
            "telephone_number": "765-759-4064",
            "fax_number": "765-759-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "LUTHER",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "765-751-2795"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60004901A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200098740",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1532717",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IU Health Yorktown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yorktown, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.