| Indian Lake School-based Health Center | |
|
8920 County Road 91 Ste 2 Lewistown OH 43333-9786 | |
| (937) 599-1411 | |
| (937) 599-4128 |
| Full Name | Indian Lake School-based Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 8920 County Road 91 Ste 2, Lewistown, Ohio |
| Authorized Official Name and Position | Tara Dawn Bair (CEO) |
| Authorized Official Contact | 9375991411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian Lake School-based Health Center 212 E Columbus Ave Ste 1 Bellefontaine OH 43311-2033 Ph: (937) 599-1411 | Indian Lake School-based Health Center 8920 County Road 91 Ste 2 Lewistown OH 43333-9786 Ph: (937) 599-1411 |
| NPI Number | 1629791900 |
|---|---|
| Provider Enumeration Date | 09/22/2022 |
| Last Update Date | 01/30/2023 |
| Medicare PECOS PAC ID | 8022247469 |
|---|---|
| Medicare Enrollment ID | O20240322002054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629791900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
Community Health And Wellness Partners Of Logan County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8920 County Road 91 Ste 2, Lewistown, OH 43333 Phone: 937-599-1411 Fax: 937-599-4128 |