Primary Care At Home, Inc. | |
7750 Michigan Rd Indianapolis IN 46268-2324 | |
(317) 471-0774 | |
(317) 471-0744 |
Full Name | Primary Care At Home, Inc. |
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Speciality | Internal Medicine |
Location | 7750 Michigan Rd, Indianapolis, Indiana |
Authorized Official Name and Position | Todd Stallings (VICE PRESIDENT) |
Authorized Official Contact | 3174710774 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primary Care At Home, Inc. 7750 Michigan Rd Indianapolis IN 46268-2324 Ph: (317) 471-0774 | Primary Care At Home, Inc. 7750 Michigan Rd Indianapolis IN 46268-2324 Ph: (317) 471-0774 |
NPI Number | 1336757103 |
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Provider Enumeration Date | 07/17/2020 |
Last Update Date | 07/17/2020 |
Medicare PECOS PAC ID | 8628495926 |
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Medicare Enrollment ID | O20200901002901 |
Identifier | Type | State | Issuer |
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1336757103 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Kurtis A Hull |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1255350674 PECOS PAC ID: 2264414556 Enrollment ID: I20040601001516 |
Provider Name | Randall K Horine |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1225083603 PECOS PAC ID: 9032197512 Enrollment ID: I20040712000161 |
Provider Name | Nadege Marc |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134841406 PECOS PAC ID: 6800264136 Enrollment ID: I20221117002418 |
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