| Community Healthnet South | |
|
6100 Broadway Merrillville IN 46410-3002 | |
| (219) 880-1190 | |
| Not Available |
| Full Name | Community Healthnet South |
|---|---|
| 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 |
|---|---|
| Community Healthnet South 1021 W 5th Ave Gary IN 46402-1703 Ph: () - | Community Healthnet South 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 |
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