| Elkhart Clinic, Llc | |
|
2120 Rieth Blvd Suite A Goshen IN 46526-5843 | |
| (574) 296-3200 | |
| (574) 296-3392 |
| Full Name | Elkhart Clinic, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2120 Rieth Blvd, Goshen, Indiana |
| Authorized Official Name and Position | Darryl R Busby (EXECUTIVE ADMINISTRATOR) |
| Authorized Official Contact | 5742963200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elkhart Clinic, Llc Po Box 2968 Elkhart IN 46515-2968 Ph: (574) 296-3390 | Elkhart Clinic, Llc 2120 Rieth Blvd Suite A Goshen IN 46526-5843 Ph: (574) 296-3200 |
| NPI Number | 1962788141 |
|---|---|
| Provider Enumeration Date | 11/01/2011 |
| Last Update Date | 11/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962788141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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Elkhart Clinic, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1122 Professional Dr, Goshen, IN 46526 Phone: 574-296-3291 Fax: 574-296-3383 | |
Goshen Health System Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2004 Elkhart Rd Ste A, Goshen, IN 46526 Phone: 574-364-2611 Fax: 574-364-2784 | |
Goshen Health System, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1814 Charlton Ct Ste A, Goshen, IN 46526 Phone: 574-533-4169 Fax: 574-534-8822 | |
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