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315 Lankford St Clay City IN 47841-1008 | |
(812) 939-2126 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 315 Lankford St, Clay City, Indiana |
Authorized Official Name and Position | Steve Holman (CEO) |
Authorized Official Contact | 8122387606 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 2505 Indianapolis IN 46206-2505 Ph: (812) 238-7783 | 315 Lankford St Clay City IN 47841-1008 Ph: (812) 939-2126 |
NPI Number | 1235120882 |
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Provider Enumeration Date | 11/02/2005 |
Last Update Date | 07/20/2023 |
Medicare PECOS PAC ID | 8426943614 |
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Medicare Enrollment ID | O20070626000727 |
Identifier | Type | State | Issuer |
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1235120882 | NPI | - | NPPES |
100079350 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |