| Longevity Clinical Ltc Associates Of Indiana, Pc | |
|
2640 Cold Spring Rd Indianapolis IN 46222-2272 | |
| (317) 923-1518 | |
| Not Available |
| Full Name | Longevity Clinical Ltc Associates Of Indiana, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2640 Cold Spring Rd, Indianapolis, Indiana |
| Authorized Official Name and Position | Diane Vincur (MANAGER) |
| Authorized Official Contact | 5618152427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity Clinical Ltc Associates Of Indiana, Pc 11780 Us Highway 1 Ste N107 North Palm Beach FL 33408-3007 Ph: (561) 815-2427 | Longevity Clinical Ltc Associates Of Indiana, Pc 2640 Cold Spring Rd Indianapolis IN 46222-2272 Ph: (317) 923-1518 |
| NPI Number | 1497581250 |
|---|---|
| Provider Enumeration Date | 09/10/2024 |
| Last Update Date | 09/10/2024 |
| Medicare PECOS PAC ID | 0345774253 |
|---|---|
| Medicare Enrollment ID | O20241114003809 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497581250 | NPI | - | NPPES |
| Provider Name | Lindsey D Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982039244 PECOS PAC ID: 3971731803 Enrollment ID: I20140122000978 |
| Provider Name | Rebecca L Koenig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407308372 PECOS PAC ID: 4183904758 Enrollment ID: I20161219000397 |
| Provider Name | Donna Gettle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144950254 PECOS PAC ID: 9931581154 Enrollment ID: I20220804003248 |
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