| Lana Bucchino Llc | |
|
1910 W Royale Dr Muncie IN 47304-2264 | |
| (765) 289-1011 | |
| (765) 289-3024 |
| Full Name | Lana Bucchino Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1910 W Royale Dr, Muncie, Indiana |
| Authorized Official Name and Position | Svetlana Bucchino (OWNER) |
| Authorized Official Contact | 7652891011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lana Bucchino Llc 1910 W Royale Dr Muncie IN 47304-2264 Ph: (765) 289-1011 | Lana Bucchino Llc 1910 W Royale Dr Muncie IN 47304-2264 Ph: (765) 289-1011 |
| NPI Number | 1760813422 |
|---|---|
| Provider Enumeration Date | 12/06/2013 |
| Last Update Date | 12/06/2013 |
| Medicare PECOS PAC ID | 1759511546 |
|---|---|
| Medicare Enrollment ID | O20140221001393 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760813422 | NPI | - | NPPES |
| 1932120847 | Other | IN | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 01057078A (Indiana) | Primary |
| Provider Name | Svetlana Bucchino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932120847 PECOS PAC ID: 5092841528 Enrollment ID: I20100410000006 |
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