| Ihc Grant-blackford | |
|
116 E 32nd St Ste A Marion IN 46953-4060 | |
| (765) 664-7492 | |
| (765) 400-4466 |
| Full Name | Ihc Grant-blackford |
|---|---|
| Speciality | Clinic/Center |
| Location | 116 E 32nd St Ste A, Marion, Indiana |
| Authorized Official Name and Position | Tracy J Nagel (CFO) |
| Authorized Official Contact | 3175761335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ihc Grant-blackford 8003 Castleway Dr Indianapolis IN 46250-1946 Ph: (317) 576-1335 | Ihc Grant-blackford 116 E 32nd St Ste A Marion IN 46953-4060 Ph: (765) 664-7492 |
| NPI Number | 1215343389 |
|---|---|
| Provider Enumeration Date | 07/09/2014 |
| Last Update Date | 07/07/2023 |
| Medicare PECOS PAC ID | 3971599473 |
|---|---|
| Medicare Enrollment ID | O20141105000240 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215343389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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