| Edgewater Health - Merrillville | |
|
5495 Broadway Merrillville IN 46410-1647 | |
| (219) 885-4264 | |
| Not Available |
| Full Name | Edgewater Health - Merrillville |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 5495 Broadway, Merrillville, Indiana |
| Authorized Official Name and Position | Danita Johnson Hughes (CEO) |
| Authorized Official Contact | 2198854264 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edgewater Health - Merrillville 1100 W 6th Ave Gary IN 46402-1711 Ph: (219) 885-4264 | Edgewater Health - Merrillville 5495 Broadway Merrillville IN 46410-1647 Ph: (219) 885-4264 |
| NPI Number | 1184303414 |
|---|---|
| Provider Enumeration Date | 07/13/2023 |
| Last Update Date | 07/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184303414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
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