| Ch Specialty Services In Llc | |
|
315 Country Club Rd Corydon IN 47112-1751 | |
| (337) 991-9276 | |
| Not Available |
| Full Name | Ch Specialty Services In Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 315 Country Club Rd, Corydon, Indiana |
| Authorized Official Name and Position | Nicole Howard (SR VP OF ADMINISTRATIVE SERVICES) |
| Authorized Official Contact | 3379919276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ch Specialty Services In Llc 1509 Dulles Dr Lafayette LA 70506-3718 Ph: (337) 991-9276 | Ch Specialty Services In Llc 315 Country Club Rd Corydon IN 47112-1751 Ph: (337) 991-9276 |
| NPI Number | 1497458731 |
|---|---|
| Provider Enumeration Date | 03/24/2023 |
| Last Update Date | 03/24/2023 |
| Medicare PECOS PAC ID | 7810354636 |
|---|---|
| Medicare Enrollment ID | O20230608002772 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497458731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Vlastimil Smetka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497974273 PECOS PAC ID: 1658424825 Enrollment ID: I20230523000850 |
| Provider Name | Brian Whyms |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821440066 PECOS PAC ID: 2365736378 Enrollment ID: I20240417004187 |
| Provider Name | Amanda Gillespie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477942092 PECOS PAC ID: 9638494537 Enrollment ID: I20240427001834 |
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