| Knox-winamac Comm. Hlth Ctrs, Inc. | |
|
105 N. Broadway San Pierre IN 46374 | |
| (219) 828-3300 | |
| (219) 828-3500 |
| Full Name | Knox-winamac Comm. Hlth Ctrs, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 105 N. Broadway, San Pierre, Indiana |
| Authorized Official Name and Position | Tracey Shorter (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5747726030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Knox-winamac Comm. Hlth Ctrs, Inc. Po Box 338 121 E. Peacl Street Winamac IN 46996 Ph: (574) 946-6196 | Knox-winamac Comm. Hlth Ctrs, Inc. 105 N. Broadway San Pierre IN 46374 Ph: (219) 828-3300 |
| NPI Number | 1184922833 |
|---|---|
| Provider Enumeration Date | 03/04/2011 |
| Last Update Date | 03/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184922833 | NPI | - | NPPES |
| 100210550A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01021497A (Indiana) | Primary |
Knox Winamac Community Health Centers, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 N Broadway St, San Pierre, IN 46374 Phone: 574-828-3020 Fax: 574-828-3044 |