Provider Demographics
NPI:1962593400
Name:TRU ARCH INC
Entity type:Organization
Organization Name:TRU ARCH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:KIDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:C PED
Authorized Official - Phone:812-232-0910
Mailing Address - Street 1:2307 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-3048
Mailing Address - Country:US
Mailing Address - Phone:812-232-0910
Mailing Address - Fax:812-232-0936
Practice Address - Street 1:2307 S 3RD ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802
Practice Address - Country:US
Practice Address - Phone:812-232-0910
Practice Address - Fax:812-232-0936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200464020AMedicaid
IL000000318389OtherANTHEM
IN4837670001Medicare ID - Type Unspecified
IN1962593400Medicare NSC