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6091 Broadway Merrillville IN 46410-2619 | |
(219) 763-8944 | |
(219) 764-5395 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 6091 Broadway, Merrillville, Indiana |
Authorized Official Name and Position | David Hall (CEO) |
Authorized Official Contact | 2197638112 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1430 Portage IN 46368-9230 Ph: (219) 763-8112 | 6091 Broadway Merrillville IN 46410-2619 Ph: (219) 763-8944 |
NPI Number | 1053905976 |
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Provider Enumeration Date | 02/22/2021 |
Last Update Date | 03/04/2022 |
Identifier | Type | State | Issuer |
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1053905976 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
3336C0002X | Pharmacy - Clinic Pharmacy | (* (Not Available)) | Secondary |
Solution Telehealth Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 W 58th Pl, Merrillville, IN 46410 Phone: 773-732-0816 | |
Workcare Occupational Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 751 E 81st Place, Merrillville, IN 46410 Phone: 219-769-4400 |