21st Century Healthcare, Llc | |
445 N Cross Pointe Blvd Ste 140 Evansville IN 47715-4011 | |
(812) 402-2003 | |
Not Available |
Full Name | 21st Century Healthcare, Llc |
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Speciality | Clinic/Center |
Location | 445 N Cross Pointe Blvd Ste 140, Evansville, Indiana |
Authorized Official Name and Position | Roy Mason Arnold (PRESIDENT) |
Authorized Official Contact | 8124022003 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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21st Century Healthcare, Llc 445 N Cross Pointe Blvd Ste 140 Evansville IN 47715-4011 Ph: (812) 402-2003 | 21st Century Healthcare, Llc 445 N Cross Pointe Blvd Ste 140 Evansville IN 47715-4011 Ph: (812) 402-2003 |
NPI Number | 1841538915 |
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Provider Enumeration Date | 01/24/2013 |
Last Update Date | 06/05/2013 |
Medicare PECOS PAC ID | 0345487286 |
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Medicare Enrollment ID | O20220909001530 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841538915 | NPI | - | NPPES |
IN1257 | Other | IN | GROUP PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 01062684A (Indiana) | Primary |
Provider Name | Roy Mason Arnold |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1215268875 PECOS PAC ID: 1254578198 Enrollment ID: I20220909001757 |
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