| East Indiana Treatment Center, Llc | |
|
816 Rudolph Way Greendale IN 47025-8312 | |
| (812) 537-1668 | |
| (812) 537-1625 |
| Full Name | East Indiana Treatment Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 816 Rudolph Way, Greendale, Indiana |
| Authorized Official Name and Position | Peter F Morris (PRESIDENT, CTC DIVISION) |
| Authorized Official Contact | 6157211297 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Indiana Treatment Center, Llc 6185 Paseo Del Norte Ste 150 Carlsbad CA 92011-1155 Ph: (760) 710-0819 | East Indiana Treatment Center, Llc 816 Rudolph Way Greendale IN 47025-8312 Ph: (812) 537-1668 |
| NPI Number | 1013060714 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 07/31/2018 |
| Medicare PECOS PAC ID | 0547694697 |
|---|---|
| Medicare Enrollment ID | O20191223001739 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013060714 | NPI | - | NPPES |
| 0279713 | Medicaid | OH | |
| 201345410A | Medicaid | IN | |
| 3000012052 | Medicaid | IN |
Orthocincy Orthopaedics & Sports Medicine Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 Flossie Dr, Greendale, IN 47025 Phone: 859-301-2663 Fax: 859-817-7848 |