Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eagle Dancer Inc

Organization Customized Equipment (DME) · NPI 1700051711

Eagle Dancer Inc is a Customized Equipment (DME) in Bloomington, Indiana. Licensed in Indiana. Registered with an NPI since 2008.

Licensed in
IN
In the registry since
2008
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

414 S College Ave
Bloomington, IN 47403-1513
Phone: (812) 331-1962
Fax: (812) 332-1949
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Customized Equipment (DME) (primary) Taxonomy 332BC3200X · Licence 280-B (IN)

Record details

NPI number1700051711
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Raymond Stidd — Provider · (812) 330-0909
NPI enumeratedApril 30, 2008
Last updated in NPPESNovember 23, 2009
Mailing address414 S College Ave, Bloomington, IN 47403-1513

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