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3400 E Market St Logansport IN 46947-2295 | |
(574) 722-9633 | |
(574) 722-5987 |
Full Name | |
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Speciality | Clinic/Center |
Location | 3400 E Market St, Logansport, Indiana |
Authorized Official Name and Position | Tara Mcvay (PRESIDENT & CEO) |
Authorized Official Contact | 5747531385 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3400 E Market St Logansport IN 46947-2295 Ph: (574) 722-9633 | 3400 E Market St Logansport IN 46947-2295 Ph: (574) 722-9633 |
NPI Number | 1821648155 |
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Provider Enumeration Date | 09/18/2019 |
Last Update Date | 08/23/2023 |
Medicare PECOS PAC ID | 8123923281 |
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Medicare Enrollment ID | O20200608000249 |
Identifier | Type | State | Issuer |
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1821648155 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Logansport Family Health Care Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1201 Michigan Avenue, Suite 270, Logansport, IN 46947 Phone: 574-722-4921 Fax: 574-739-0520 | |