| Gary City Urgent And Immediate Care Llc | |
|
1701 Broadway Gary IN 46407-2238 | |
| (219) 882-0980 | |
| Not Available |
| Full Name | Gary City Urgent And Immediate Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1701 Broadway, Gary, Indiana |
| Authorized Official Name and Position | Paul Okolocha (OWNER) |
| Authorized Official Contact | 2198820980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary City Urgent And Immediate Care Llc 1701 Broadway Gary IN 46407-2238 Ph: (219) 882-0980 | Gary City Urgent And Immediate Care Llc 1701 Broadway Gary IN 46407-2238 Ph: (219) 882-0980 |
| NPI Number | 1164033676 |
|---|---|
| Provider Enumeration Date | 08/10/2020 |
| Last Update Date | 02/08/2023 |
| Medicare PECOS PAC ID | 1052723483 |
|---|---|
| Medicare Enrollment ID | O20201209001114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164033676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Paul C Okolocha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629193321 PECOS PAC ID: 2860421104 Enrollment ID: I20100522000064 |
| Provider Name | Sandra Renee Gates Manna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124396072 PECOS PAC ID: 0749431203 Enrollment ID: I20121108000643 |
| Provider Name | Hanifa Waarith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205426723 PECOS PAC ID: 4789099052 Enrollment ID: I20210218001629 |
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