| |
99 E Dewey St Logansport IN 46947-4933 | |
(574) 737-8634 | |
(574) 217-4825 |
Full Name | |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 99 E Dewey St, Logansport, Indiana |
Authorized Official Name and Position | Ben Park (PRESIDENT OF AHN) |
Authorized Official Contact | 3175806303 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
10333 N Meridian St Suite 230 Indianapolis IN 46290-1150 Ph: (317) 582-3937 | 99 E Dewey St Logansport IN 46947-4933 Ph: (574) 737-8634 |
NPI Number | 1609239169 |
---|---|
Provider Enumeration Date | 04/01/2016 |
Last Update Date | 04/01/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609239169 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 01065108A (Indiana) | Primary |
261QP2300X | Clinic/center - Primary Care | 71000987B (Indiana) | Secondary |
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 | |