| Glorious Mobile Clinic &telemedicine Llc | |
|
12392 Cool Winds Way Fishers IN 46037-4488 | |
| (317) 605-2630 | |
| Not Available |
| Full Name | Glorious Mobile Clinic &telemedicine Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12392 Cool Winds Way, Fishers, Indiana |
| Authorized Official Name and Position | Gloria Chidinma Nwachukwu (NURSE PRACTITIONER) |
| Authorized Official Contact | 3176052630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glorious Mobile Clinic &telemedicine Llc 12392 Cool Winds Way Fishers IN 46037-4488 Ph: (317) 605-2630 | Glorious Mobile Clinic &telemedicine Llc 12392 Cool Winds Way Fishers IN 46037-4488 Ph: (317) 605-2630 |
| NPI Number | 1124763214 |
|---|---|
| Provider Enumeration Date | 05/03/2022 |
| Last Update Date | 05/03/2022 |
| Medicare PECOS PAC ID | 1456724848 |
|---|---|
| Medicare Enrollment ID | O20230306002243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124763214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Gloria Chidinma Nwachukwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033654231 PECOS PAC ID: 9638452410 Enrollment ID: I20170202001323 |
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