| Aspire Indiana Health-boone County | |
|
1600 W Main St Lebanon IN 46052-2388 | |
| (765) 335-7702 | |
| (765) 482-2709 |
| Full Name | Aspire Indiana Health-boone County |
|---|---|
| Speciality | Clinic/Center |
| Location | 1600 W Main St, Lebanon, Indiana |
| Authorized Official Name and Position | Timothy D Crockett (CFO) |
| Authorized Official Contact | 3175870505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspire Indiana Health-boone County 9615 E 148th St Ste 1 Noblesville IN 46060-4371 Ph: (317) 571-1818 | Aspire Indiana Health-boone County 1600 W Main St Lebanon IN 46052-2388 Ph: (765) 335-7702 |
| NPI Number | 1851890107 |
|---|---|
| Provider Enumeration Date | 02/01/2018 |
| Last Update Date | 11/03/2023 |
| Medicare PECOS PAC ID | 8921314196 |
|---|---|
| Medicare Enrollment ID | O20180212000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851890107 | NPI | - | NPPES |
| 300010986 | Medicaid | IN | |
| 151014 | Other | IN | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Witham Health Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2605 N Lebanon St, Lebanon, IN 46052 Phone: 765-485-8000 | |
Boone County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 116 W Washington St Ste B202, Lebanon, IN 46052 Phone: 765-482-3942 Fax: 765-483-4450 | |
Boone County Community Health Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 416 W Camp St, Lebanon, IN 46052 Phone: 765-483-4469 |