Provider Demographics
NPI:1184692220
Name:HETZLER OCULAR PROSTHETICS, INC
Entity type:Organization
Organization Name:HETZLER OCULAR PROSTHETICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/INSURANCE COORDIANTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:OCULAR PROSTHETICS
Authorized Official - Last Name:RUMSCHLAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-598-6299
Mailing Address - Street 1:10173 ALLISONVILLE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2081
Mailing Address - Country:US
Mailing Address - Phone:317-598-6298
Mailing Address - Fax:317-598-6296
Practice Address - Street 1:10173 ALLISONVILLE RD STE 200
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2081
Practice Address - Country:US
Practice Address - Phone:317-598-6298
Practice Address - Fax:317-598-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000189172OtherANTHEM
IN100178200Medicaid
IN0171820001Medicare NSC