Provider Demographics
NPI:1255406369
Name:REHABILITATION HOSPITAL OF INDIANA, INC.
Entity type:Organization
Organization Name:REHABILITATION HOSPITAL OF INDIANA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR ACCT FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-329-2000
Mailing Address - Street 1:4141 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-2607
Mailing Address - Country:US
Mailing Address - Phone:317-329-2000
Mailing Address - Fax:317-329-2600
Practice Address - Street 1:4141 SHORE DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-2607
Practice Address - Country:US
Practice Address - Phone:317-329-2000
Practice Address - Fax:317-329-2600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06-005971-1283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN016661POtherSIHO
IN100274620AMedicaid
IN000000097990OtherANTHEM PIN
IN68192OtherMMG
INI014220OtherCHAMPUS
IN153028Medicare Oscar/Certification
INC30976Medicare PIN
IN276010Medicare PIN
IN220860Medicare PIN
INI014220OtherCHAMPUS