| Heart Care Llc | |
|
7806 W Jefferson Blvd Suite D Fort Wayne IN 46804-4180 | |
| (260) 432-7000 | |
| (260) 969-9119 |
| Full Name | Heart Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7806 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Subhash K. Reddy (OWNER) |
| Authorized Official Contact | 2604327000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heart Care Llc 7806 W Jefferson Blvd Suite D Fort Wayne IN 46804-4180 Ph: (260) 432-7000 | Heart Care Llc 7806 W Jefferson Blvd Suite D Fort Wayne IN 46804-4180 Ph: (260) 432-7000 |
| NPI Number | 1780919886 |
|---|---|
| Provider Enumeration Date | 10/07/2009 |
| Last Update Date | 01/04/2012 |
| Medicare PECOS PAC ID | 0941347629 |
|---|---|
| Medicare Enrollment ID | O20091029000098 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780919886 | NPI | - | NPPES |
| 200975120A | Medicaid | IN | |
| 200975120B | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Secondary |
| Provider Name | Subhash K Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821068511 PECOS PAC ID: 1254488620 Enrollment ID: I20090422000410 |
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