NPIMap

Organization Active NPI

Indiana Cancer Specialists, LLC

  • Durable Medical Equipment & Medical Supplies
  • Avon, IN
National Provider Identifier
1811437460
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
INDIANA CANCER SPECIALISTS, LLC
Practice address
1111 Ronald Reagan Pkwy
Suite B1500
Avon, IN 46123-7085
Phone
(317) 217-2244
Fax
(317) 217-2240
NPI assigned
Mar 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Authorized official

Name
Sridhar Bolla, MD
Title
President
Phone
(317) 228-3393

Specialties & licenses 1

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

Addresses

Primary practice location

1111 Ronald Reagan Pkwy
Suite B1500
Avon, IN 46123-7085

Mailing address

8301 Harcourt Rd
Suite 205
Indianapolis, IN 46260-2081
Phone (317) 228-3393

National Provider Directory

National Provider Directory
Tax ID family
Indiana Cancer Specialists LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

1111 Ronald Reagan Pkwy
Ste B1500
Avon, IN 46123
Phone (317) 217-2244

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1811437460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 HARCOURT RD",
            "address_2": "SUITE 205",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602081",
            "telephone_number": "317-228-3393",
            "fax_number": "317-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 RONALD REAGAN PKWY",
            "address_2": "SUITE B1500",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237085",
            "telephone_number": "317-217-2244",
            "fax_number": "317-217-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA CANCER SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "BOLLA",
        "authorized_official_first_name": "SRIDHAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-228-3393",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.