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5325 N Cougar Rd New Carlisle IN 46552-9505 | |
(864) 501-0751 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 5325 N Cougar Rd, New Carlisle, Indiana |
Authorized Official Name and Position | Jan Hopkins (ASSOC. OPS MGR) |
Authorized Official Contact | 8645010751 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 | 5325 N Cougar Rd New Carlisle IN 46552-9505 Ph: (864) 501-0751 |
NPI Number | 1275179541 |
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Provider Enumeration Date | 11/21/2019 |
Last Update Date | 03/25/2022 |
Identifier | Type | State | Issuer |
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1275179541 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |