Community Healthnet Inc | |
3503 Martin Luther King Drive Community Healthnet Inc - East Gary IN 46409-1233 | |
(219) 880-1190 | |
(219) 880-0784 |
Full Name | Community Healthnet Inc |
---|---|
Speciality | Clinic/Center |
Location | 3503 Martin Luther King Drive, Gary, Indiana |
Authorized Official Name and Position | Janet Seabrook (CEO) |
Authorized Official Contact | 2198801190 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Community Healthnet Inc 1021 W 5th Ave Gary IN 46402-1703 Ph: (219) 880-1190 | Community Healthnet Inc 3503 Martin Luther King Drive Community Healthnet Inc - East Gary IN 46409-1233 Ph: (219) 880-1190 |
NPI Number | 1891262762 |
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Provider Enumeration Date | 10/30/2018 |
Last Update Date | 10/30/2018 |
Medicare PECOS PAC ID | 6305852344 |
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Medicare Enrollment ID | O20191202000125 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891262762 | NPI | - | NPPES |
200197530 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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