Provider Demographics
NPI:1023613403
Name:STATE OF INDIANA, AUDITOR OF STATE
Entity type:Organization
Organization Name:STATE OF INDIANA, AUDITOR OF STATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STATE HEALTH COMMISSIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-233-7400
Mailing Address - Street 1:2 N MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3021
Mailing Address - Country:US
Mailing Address - Phone:317-233-7400
Mailing Address - Fax:
Practice Address - Street 1:2 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-3021
Practice Address - Country:US
Practice Address - Phone:317-233-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF INDIANA AUDITOR OF STATE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100284680AMedicaid