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440 E Us Highway 36 Bainbridge IN 46105-9608 | |
(765) 522-2556 | |
(765) 522-2560 |
Full Name | |
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Speciality | Clinic/Center |
Location | 440 E Us Highway 36, Bainbridge, Indiana |
Authorized Official Name and Position | Andrea Lee Mescall (ACCOUNTANT) |
Authorized Official Contact | 7656552576 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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440 E Us Highway 36 Bainbridge IN 46105-9608 Ph: (765) 522-2556 | 440 E Us Highway 36 Bainbridge IN 46105-9608 Ph: (765) 522-2556 |
NPI Number | 1376601559 |
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Provider Enumeration Date | 12/04/2006 |
Last Update Date | 06/25/2013 |
Medicare PECOS PAC ID | 1951396605 |
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Medicare Enrollment ID | O20130513000122 |
Identifier | Type | State | Issuer |
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1376601559 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |