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500 W Votaw St Suite A Portland IN 47371-1322 | |
(765) 288-1928 | |
(765) 741-0335 |
Full Name | |
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Speciality | Clinic/Center |
Location | 500 W Votaw St, Portland, Indiana |
Authorized Official Name and Position | Kirk Shafer (CFO) |
Authorized Official Contact | 7652881928 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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240 N Tillotson Ave Muncie IN 47304-3988 Ph: (765) 288-1928 | 500 W Votaw St Suite A Portland IN 47371-1322 Ph: (765) 288-1928 |
NPI Number | 1457803769 |
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Provider Enumeration Date | 11/03/2016 |
Last Update Date | 12/02/2016 |
Medicare PECOS PAC ID | 5597679845 |
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Medicare Enrollment ID | O20170118002510 |
Identifier | Type | State | Issuer |
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1457803769 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
Meridian Health Services Corp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 931 W Water St Ste A, Portland, IN 47371 Phone: 260-726-9348 | |
Meridian Health Services Corp. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2072 In-67, Portland, IN 47371 Phone: 765-729-8247 | |
Meridian Health Services Corp. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 406 W Votaw St, Portland, IN 47371 Phone: 765-288-1928 | |
Vormohr Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1758 W 100 S, Portland, IN 47371 Phone: 260-726-7616 Fax: 260-726-8165 |