Provider Demographics
NPI:1174615702
Name:I CARE CENTER LLC
Entity type:Organization
Organization Name:I CARE CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:317-848-1763
Mailing Address - Street 1:9002 N MERIDIAN ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5381
Mailing Address - Country:US
Mailing Address - Phone:317-848-1763
Mailing Address - Fax:317-848-1895
Practice Address - Street 1:9002 N MERIDIAN ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5381
Practice Address - Country:US
Practice Address - Phone:317-848-1763
Practice Address - Fax:317-848-1895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05-008655-1261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200043530AMedicaid
IN000000098112OtherANTHEM BLUE CROSS & BLUE
IN490002715OtherRAILROAD MEDICARE
IN490002715OtherRAILROAD MEDICARE