| Cutting Edge Integrative Pain Centers Llc | |
|
242 Waterfall Dr Ste B Elkhart IN 46516 | |
| (574) 389-7737 | |
| (574) 389-3196 |
| Full Name | Cutting Edge Integrative Pain Centers Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 242 Waterfall Dr Ste B, Elkhart, Indiana |
| Authorized Official Name and Position | Orlando Landrum (OWNER) |
| Authorized Official Contact | 5743897737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cutting Edge Integrative Pain Centers Llc 242 Waterfall Dr Ste B Elkhart IN 46516-3647 Ph: (574) 389-7737 | Cutting Edge Integrative Pain Centers Llc 242 Waterfall Dr Ste B Elkhart IN 46516 Ph: (574) 389-7737 |
| NPI Number | 1790215168 |
|---|---|
| Provider Enumeration Date | 06/18/2017 |
| Last Update Date | 05/22/2018 |
| Medicare PECOS PAC ID | 1355698309 |
|---|---|
| Medicare Enrollment ID | O20180720002557 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790215168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Orlando A Landrum |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1932159910 PECOS PAC ID: 0042229387 Enrollment ID: I20110606000129 |
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