Wellstone Regional Hospital Acquisition Llc | |
2700 Vissing Park Rd Jeffersonville IN 47130-5943 | |
(812) 284-8000 | |
(812) 258-2023 |
Full Name | Wellstone Regional Hospital Acquisition Llc |
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Speciality | Community/Behavioral Health |
Location | 2700 Vissing Park Rd, Jeffersonville, Indiana |
Authorized Official Name and Position | Dean Saling (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2182581044 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wellstone Regional Hospital Acquisition Llc 2700 Vissing Park Rd Jeffersonville IN 47130-5943 Ph: (812) 284-8000 | Wellstone Regional Hospital Acquisition Llc 2700 Vissing Park Rd Jeffersonville IN 47130-5943 Ph: (812) 284-8000 |
NPI Number | 1194864843 |
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Provider Enumeration Date | 02/06/2007 |
Last Update Date | 05/27/2008 |
Medicare PECOS PAC ID | 3577585066 |
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Medicare Enrollment ID | O20070608000026 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194864843 | NPI | - | NPPES |
200820740 | Medicaid | IN | |
65945685 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Asad Ismail |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1144227026 PECOS PAC ID: 7214926195 Enrollment ID: I20040506001422 |
Provider Name | Eric Lydon |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1609873579 PECOS PAC ID: 3072406669 Enrollment ID: I20050307000489 |
Provider Name | Mohammad A Mian |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1881796183 PECOS PAC ID: 4789621681 Enrollment ID: I20050412001258 |
Provider Name | Ross E Nunes |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1366588824 PECOS PAC ID: 7315192424 Enrollment ID: I20130221000081 |
Provider Name | Sufian Ahmad |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1821352824 PECOS PAC ID: 0244529873 Enrollment ID: I20210226002175 |
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