EAGLE DANCER INC (NPI# 1700051711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700051711 |
| Entity Type | Organization |
| Organization Name | EAGLE DANCER INC |
| Practice Address |
414 S College Ave Bloomington IN 47403-1513 |
| Practice Telephone | 8123311962 |
| Practice Fax Number | 8123321949 |
| Mailing Telephone | 8123311962 |
| Mailing Fax Number | 8123321949 |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2009-11-23 |
| Authorized Official Name | RAYMOND STIDD (PROVIDER) |
| Authorized Official Telephone | 8123300909 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
280-B | IN | Suppliers |
| Street Address |
414 S COLLEGE AVE |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47403-1513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
| 1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
| 1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
| 1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
| 1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
| 1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
| 1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
| 1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
| 1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
| 1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
| Find all providers in zip 47403 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821280488 | Stellar Orthopedics, Inc. | Durable Medical Equipment & Medical Supplies | 3104 Auburn Rd, Bloomington, IL 61704-8576 | 2007-08-16 |
| 1144384074 | Restwell Mattress Company | Durable Medical Equipment & Medical Supplies | 7953 Southtown Ctr, Bloomington, MN 55431-1323 | 2006-12-22 |
| 1245343292 | Central Brace & Limb Co., Inc. | Durable Medical Equipment & Medical Supplies | 641 S Walker St, Bloomington, IN 47403-2178 | 2006-08-16 |
| 1750682738 | Home Health Depot Inc | Durable Medical Equipment & Medical Supplies | 105 Krispy Kreme Dr, Suite 3, Bloomington, IL 61704-3751 | 2010-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700402989 | Patients Choice, LLC | Durable Medical Equipment & Medical Supplies | 12680 Ford Dr, Fishers, IN 46038-2892 | 2020-06-23 |
| 1770108169 | Rehab Medical, LLC | Durable Medical Equipment & Medical Supplies | 15252 Stony Creek Way Ste 103, Noblesville, IN 46060-4390 | 2020-06-11 |
| 1154945657 | Indianapolis Medical Suppliers LLC | Durable Medical Equipment & Medical Supplies | 7241 E 146th St, Carmel, IN 46033-9858 | 2020-06-01 |
| 1215557137 | Mp Supports LLC | Durable Medical Equipment & Medical Supplies | 1178 Fremont Ct Ste 1f, Elkhart, IN 46516-9321 | 2020-04-21 |
| 1821645169 | Eperture LLC | Durable Medical Equipment & Medical Supplies | 4070 25th St, Columbus, IN 47203-3161 | 2019-08-21 |
| 1588219729 | Crossings Clinic LLC | Durable Medical Equipment & Medical Supplies | 5520 E Highway 62, Jeffersonville, IN 47130-8735 | 2019-08-05 |
| 1972069904 | At Home Health Equipment LLC | Durable Medical Equipment & Medical Supplies | 200 E Lincoln Rd, Kokomo, IN 46902-3564 | 2019-02-14 |
| 1003383233 | Bombeauty Supply and Salon | Durable Medical Equipment & Medical Supplies | 3010 Lake Shore Dr Unit A, Indianapolis, IN 46205 | 2018-10-25 |
| 1407342157 | Vivian Ann Allen-baer | Durable Medical Equipment & Medical Supplies | 2316 Gutford Rd, Clarksville, IN 47129-9048 | 2018-07-05 |
| 1336631753 | Nwi Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 1454 E. 86th Place, Merrillville, IN 46410 | 2018-06-01 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 47403 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.