| Indiana Community Health Medical Center, Inc. | |
|
111 Arrowhead Trl Bedford IN 47421-5820 | |
| (812) 203-4718 | |
| Not Available |
| Full Name | Indiana Community Health Medical Center, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 111 Arrowhead Trl, Bedford, Indiana |
| Authorized Official Name and Position | Michael Kane (BOARD MEMBER) |
| Authorized Official Contact | 8128043400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indiana Community Health Medical Center, Inc. 111 Arrowhead Trl Bedford IN 47421-5820 Ph: (812) 203-4718 | Indiana Community Health Medical Center, Inc. 111 Arrowhead Trl Bedford IN 47421-5820 Ph: (812) 203-4718 |
| NPI Number | 1093392870 |
|---|---|
| Provider Enumeration Date | 03/26/2021 |
| Last Update Date | 12/01/2021 |
| Medicare PECOS PAC ID | 3971908252 |
|---|---|
| Medicare Enrollment ID | O20210825000933 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093392870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Michael W Kane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497891840 PECOS PAC ID: 1557259256 Enrollment ID: I20040305000069 |
| Provider Name | Kelly J Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932437514 PECOS PAC ID: 9537296371 Enrollment ID: I20100427000330 |
| Provider Name | Amy R Burchett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255905246 PECOS PAC ID: 3274931621 Enrollment ID: I20211014003233 |
| Provider Name | Angela Nicole Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730960428 PECOS PAC ID: 9739537929 Enrollment ID: I20231129000266 |
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