| Lake Shore Clinic | |
|
921 N Lake Shore Dr Culver IN 46511-1207 | |
| (574) 842-4330 | |
| Not Available |
| Full Name | Lake Shore Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 921 N Lake Shore Dr, Culver, Indiana |
| Authorized Official Name and Position | Judith A Deery (BUSINESS MANAGER) |
| Authorized Official Contact | 5748423327 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Shore Clinic 921 N Lake Shore Dr Culver IN 46511-1207 Ph: (574) 842-4330 | Lake Shore Clinic 921 N Lake Shore Dr Culver IN 46511-1207 Ph: (574) 842-4330 |
| NPI Number | 1366566424 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 06/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366566424 | NPI | - | NPPES |
| 15D0356500 | Other | IN | CLIA NUMBER |
| 207Q000000X | Other | IN | TAXONOMY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 207Q000000X (Indiana) | Primary |
Ourclinic @ Culver Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 N Terrace Dr, Culver, IN 46511 Phone: 574-842-8882 | |
Pulaski Memorial Hospital Culver Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 232 S Main St Ste A, Culver, IN 46511 Phone: 574-946-2584 |