| Liberty Clinic Llc | |
|
1103 E Grace St Rensselaer IN 47978-3210 | |
| (219) 866-4135 | |
| (219) 866-0803 |
| Full Name | Liberty Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1103 E Grace St, Rensselaer, Indiana |
| Authorized Official Name and Position | Randy Curtis Lehman (OWNER) |
| Authorized Official Contact | 2198664135 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Clinic Llc 1103 E Grace St Rensselaer IN 47978-3210 Ph: (219) 866-4135 | Liberty Clinic Llc 1103 E Grace St Rensselaer IN 47978-3210 Ph: (219) 866-4135 |
| NPI Number | 1285302430 |
|---|---|
| Provider Enumeration Date | 09/02/2021 |
| Last Update Date | 06/02/2022 |
| Medicare PECOS PAC ID | 6800294083 |
|---|---|
| Medicare Enrollment ID | O20211004001069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285302430 | NPI | - | NPPES |
| 1912388414 | Other | INDIVIDUAL NPI | |
| 300057753 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Melissa Sue Cain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871795047 PECOS PAC ID: 9830266766 Enrollment ID: I20080918000522 |
| Provider Name | Randy C Lehman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912388414 PECOS PAC ID: 4981916830 Enrollment ID: I20200713001106 |
| Provider Name | Taylor A Snodgrass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104574037 PECOS PAC ID: 5799172201 Enrollment ID: I20220503000230 |
| Provider Name | Emily Fritz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205564101 PECOS PAC ID: 0244606986 Enrollment ID: I20221020000647 |
Sheets Family Practice P.c. Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 123 S Mckinley Ave, Rensselaer, IN 47978 Phone: 219-866-1890 Fax: 219-866-1871 | |
Clinic Of Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1103 E Grace St, Rensselaer, IN 47978 Phone: 219-866-4135 Fax: 219-866-7047 | |
Christian Clinic Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 716 S College Ave, Rensselaer, IN 47978 Phone: 219-866-0485 Fax: 219-866-0837 | |
Robert E Darnaby Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 W Washington St, Rensselaer, IN 47978 Phone: 219-866-4135 Fax: 219-866-0803 | |
Louck Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 W Drexel Pkwy, Rensselaer, IN 47978 Phone: 219-866-4300 Fax: 219-866-7591 |