| |
6100 Broadway Merrillville IN 46410-3002 | |
(219) 880-1190 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 6100 Broadway, Merrillville, Indiana |
Authorized Official Name and Position | Janet Seabrook (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2194842442 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1021 W 5th Ave Gary IN 46402-1703 Ph: () - | 6100 Broadway Merrillville IN 46410-3002 Ph: (219) 880-1190 |
NPI Number | 1952660243 |
---|---|
Provider Enumeration Date | 05/08/2012 |
Last Update Date | 11/01/2013 |
Medicare PECOS PAC ID | 6305852344 |
---|---|
Medicare Enrollment ID | O20130904000354 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952660243 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Solution Telehealth Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 W 58th Pl, Merrillville, IN 46410 Phone: 773-732-0816 | |
Workcare Occupational Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 751 E 81st Place, Merrillville, IN 46410 Phone: 219-769-4400 |