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Contact Information

INDIANA UNIVERSITY HEALTH PROTON THERAPY CENTER, LLC
2425 MILO B. SAMPSON LANE
BLOOMINGTON, IN47408-1398
 Phone: 812-349-5074
 Fax: 812-349-5046
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oncology, Radiation

261QX0203X
Indicates primary specialty

NPI Profile & details for INDIANA UNIVERSITY HEALTH PROTON THERAPY CENTER, LLC

NPI Number 1780775163
LBN Legal business name INDIANA UNIVERSITY HEALTH PROTON THERAPY CENTER, LLC
Authorized official JOHN KERSTIENS - (COO/CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 09/28/2006
Last updated 11/28/2012 - About 14 years ago
Identifiers
License # NA
IN Medicaid 200442910A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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