Provider Demographics
NPI:1396972345
Name:KAREN SMITH
Entity type:Organization
Organization Name:KAREN SMITH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:317-364-2122
Mailing Address - Street 1:2049 N MORRISTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46716
Mailing Address - Country:US
Mailing Address - Phone:317-392-0875
Mailing Address - Fax:317-392-0287
Practice Address - Street 1:2049 N MORRISTOWN RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-9408
Practice Address - Country:US
Practice Address - Phone:317-392-0875
Practice Address - Fax:317-392-0287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies