| |
51 E Market St Cloverdale IN 46120-8427 | |
(765) 795-4242 | |
(765) 795-4456 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 51 E Market St, Cloverdale, Indiana |
Authorized Official Name and Position | Julie A Battin (OFFICE MANAGER) |
Authorized Official Contact | 7657954242 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 508 Cloverdale IN 46120-0508 Ph: (765) 795-4242 | 51 E Market St Cloverdale IN 46120-8427 Ph: (765) 795-4242 |
NPI Number | 1578621389 |
---|---|
Provider Enumeration Date | 12/05/2006 |
Last Update Date | 06/18/2013 |
Medicare PECOS PAC ID | 1951396605 |
---|---|
Medicare Enrollment ID | O20130513000101 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578621389 | NPI | - | NPPES |
100268700F | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |