| Damar Services Inc | |
|
6067 Decatur Blvd Indianapolis IN 46241-9606 | |
| (317) 856-5201 | |
| (317) 856-2333 |
| Full Name | Damar Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6067 Decatur Blvd, Indianapolis, Indiana |
| Authorized Official Name and Position | Jim L. Dalton (CEO) |
| Authorized Official Contact | 3172814545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Damar Services Inc 6067 Decatur Blvd Indianapolis IN 46241-9606 Ph: (317) 856-5201 | Damar Services Inc 6067 Decatur Blvd Indianapolis IN 46241-9606 Ph: (317) 856-5201 |
| NPI Number | 1427154814 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 07/17/2024 |
| Certification Date | 07/17/2024 |
| Medicare PECOS PAC ID | 9931180460 |
|---|---|
| Medicare Enrollment ID | O20040528000970 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427154814 | NPI | - | NPPES |
| 300011498 | Medicaid | IN | |
| 300046999 | Medicaid | IN | |
| 300086681 | Medicaid | IN | |
| 300015288 | Medicaid | IN | |
| 300019912 | Medicaid | IN | |
| 200437920A | Medicaid | IN | |
| 300093086 | Medicaid | IN | |
| 200437920C | Medicaid | IN | |
| 300020167 | Medicaid | IN | |
| 300066992 | Medicaid | IN | |
| 200437920B | Medicaid | IN | |
| 300014736 | Medicaid | IN | |
| 300018560 | Medicaid | IN | |
| 300020100 | Medicaid | IN | |
| 300014451 | Medicaid | IN |
| Provider Name | James L Dalton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912046004 PECOS PAC ID: 3870575921 Enrollment ID: I20040607000574 |
| Provider Name | John D Riley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841394830 PECOS PAC ID: 1052486685 Enrollment ID: I20100928000687 |
| Provider Name | Ryan Shepherd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801634894 PECOS PAC ID: 4688112485 Enrollment ID: I20240813002194 |
| Provider Name | Mary Rembusch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316256654 PECOS PAC ID: 9739627845 Enrollment ID: I20240820001305 |
| Provider Name | Katie Watkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437982592 PECOS PAC ID: 4880134923 Enrollment ID: I20240904002910 |
| Provider Name | Julia Lane Mitchell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356509954 PECOS PAC ID: 0345462883 Enrollment ID: I20240910000430 |
| Provider Name | Sarah Wicker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609501238 PECOS PAC ID: 7214468271 Enrollment ID: I20241001002235 |
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