Pnw Clinic | |
2250 173rd St Ste 111 Hammond IN 46323-2074 | |
(219) 769-4005 | |
Not Available |
Full Name | Pnw Clinic |
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Speciality | Clinic/Center |
Location | 2250 173rd St Ste 111, Hammond, Indiana |
Authorized Official Name and Position | Judith Sikora (CFO) |
Authorized Official Contact | 2197571921 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Pnw Clinic 8555 Taft St Merrillville IN 46410-6123 Ph: (219) 769-4005 | Pnw Clinic 2250 173rd St Ste 111 Hammond IN 46323-2074 Ph: (219) 769-4005 |
NPI Number | 1023642576 |
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Provider Enumeration Date | 02/24/2020 |
Last Update Date | 02/26/2020 |
Medicare PECOS PAC ID | 5991600355 |
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Medicare Enrollment ID | O20200312001634 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023642576 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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