Provider Demographics
NPI:1396142964
Name:INDIANA UNIVERSITY HEALTH INC
Entity type:Organization
Organization Name:INDIANA UNIVERSITY HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SORGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-948-1598
Mailing Address - Street 1:3988 SOLUTIONS CTR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-3009
Mailing Address - Country:US
Mailing Address - Phone:317-963-9730
Mailing Address - Fax:317-963-5003
Practice Address - Street 1:390 AIRTECH PKWY STE 106A
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-7456
Practice Address - Country:US
Practice Address - Phone:317-963-7100
Practice Address - Fax:317-963-7110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-26
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336S0011X
IN60006420A3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201272230AMedicaid
2149229OtherPK
1133670035Medicare NSC