National Provider Identifier Database

GLENDALE ADVANCED HEALTH LLC
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.


Contact Information

GLENDALE ADVANCED HEALTH, LLC
6321 N. KEYSTONE AVE
STE. B
INDIANAPOLIS, IN46220
Phone: 317-257-2225
Fax:
Website:
Specialty Taxonomy Code
* General Practice 208D00000X

* Indicates primary specialty

NPI Profile & details for GLENDALE ADVANCED HEALTH, LLC

NPI Number 1992311104
Legal business name
LBN
GLENDALE ADVANCED HEALTH, LLC
Authorized official JOSEPH FORTUNATO - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 09/22/2020
Last updated 09/23/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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