GLENDALE ADVANCED HEALTH, LLC – NPI #1992311104
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

GLENDALE ADVANCED HEALTH, LLC is a provider located in INDIANAPOLIS, IN. NPPES has assigned the NPI number 1992311104 to GLENDALE ADVANCED HEALTH, LLC on September 22, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

The NPI profile was previously updated about 5 years ago on Sep 23, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GLENDALE ADVANCED HEALTH, LLC below.

NPI Profile for
GLENDALE ADVANCED HEALTH, LLC

NPI Number
1992311104
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GLENDALE ADVANCED HEALTH, LLC
Primary location
6321 N. KEYSTONE AVE
STE. B
INDIANAPOLIS, IN 46220
Phone: (317) 257-2225 Fax:
Mailing address
6321 N KEYSTONE AVE
SUITE B
INDIANAPOLIS, IN 46220-2156
Phone: (317) 257-2225 Fax:
Organization Subpart
No
Authorized Official
JOSEPH FORTUNATO
OWNER
Phone: (317) 257-2225
Updated
Certification Date
Sep 01, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.