Active Athlete Sports Medicine Psc

LBN: Active Athlete Sports Medicine Psc
Active Athlete Sports Medicine Psc is an health care organization with primary practice located at 3891 Charlestown Rd , New Albany IN 47150-9562. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as the primary health care specialty. Active Athlete Sports Medicine Psc can be contacted via phone (812) 949-3482, or through Roberts, Tricia via phone (812) 949-3482.

Contact Information

Primary practice address
3891 Charlestown Rd New Albany IN 47150-9562
Phone: (812) 949-3482
Fax: (812) 812-9418
Website:
Map and Directions
Authorized official contact:
Name: Roberts, Tricia
Phone: (812) 949-3482

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 01033436A Indiana

Profile Details

NPI number 1699920272
LBN Legal business name Active Athlete Sports Medicine Psc
DBA Doing business as
Authorized official Roberts, Tricia
Entity Organization
Organization subpart 1 No
Enumeration date Nov 24th, 2008
Last updated Feb 24th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699920272 NPPES
Indiana MEDICAID 100327800

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