| Elkhart Clinic, Llc | |
|
5314 Lincolnway E Mishawaka IN 46544-4249 | |
| (574) 256-9032 | |
| (574) 256-9049 |
| Full Name | Elkhart Clinic, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 5314 Lincolnway E, Mishawaka, 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) 296-3200 | Elkhart Clinic, Llc 5314 Lincolnway E Mishawaka IN 46544-4249 Ph: (574) 256-9032 |
| NPI Number | 1689950867 |
|---|---|
| Provider Enumeration Date | 11/01/2011 |
| Last Update Date | 11/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689950867 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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