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720 N Marr Rd Ste A Columbus IN 47201-6660 | |
| (812) 314-3400 | |
| (812) 376-4875 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 720 N Marr Rd Ste A, Columbus, Indiana |
| Authorized Official Name and Position | Jenny Harrison (CEO) |
| Authorized Official Contact | 8123508249 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
645 S Rogers St Ste A Bloomington IN 47403-2353 Ph: (812) 339-1691 | 720 N Marr Rd Ste A Columbus IN 47201-6660 Ph: (812) 314-3400 |
| NPI Number | 1114553948 |
|---|---|
| Provider Enumeration Date | 03/12/2020 |
| Last Update Date | 03/11/2024 |
| Medicare PECOS PAC ID | 1850497173 |
|---|---|
| Medicare Enrollment ID | O20210721001332 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114553948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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