Provider Demographics
NPI:1134564016
Name:CHN JMH VENTURES LLC
Entity type:Organization
Organization Name:CHN JMH VENTURES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AMULATORY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:E
Authorized Official - Last Name:FOHRER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-621-7432
Mailing Address - Street 1:7330 SHADELAND STATION
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3985
Mailing Address - Country:US
Mailing Address - Phone:317-621-7432
Mailing Address - Fax:317-621-7422
Practice Address - Street 1:3000 S STATE ROAD 135 STE 120
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-9829
Practice Address - Country:US
Practice Address - Phone:317-621-7432
Practice Address - Fax:317-621-7422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-06
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201204130AMedicaid
IN201204130AMedicaid