| Pulaski Memorial Hospital North Judson Family Medicine | |
|
414 Lane St North Judson IN 46366-1226 | |
| (574) 896-4325 | |
| Not Available |
| Full Name | Pulaski Memorial Hospital North Judson Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 414 Lane St, North Judson, Indiana |
| Authorized Official Name and Position | Gregg Malott (CFO) |
| Authorized Official Contact | 5749462103 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pulaski Memorial Hospital North Judson Family Medicine Po Box 279 Winamac IN 46996-0279 Ph: (574) 946-2100 | Pulaski Memorial Hospital North Judson Family Medicine 414 Lane St North Judson IN 46366-1226 Ph: (574) 896-4325 |
| NPI Number | 1831679620 |
|---|---|
| Provider Enumeration Date | 08/21/2018 |
| Last Update Date | 10/11/2022 |
| Medicare PECOS PAC ID | 3173515509 |
|---|---|
| Medicare Enrollment ID | O20171016003253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831679620 | NPI | - | NPPES |
| 300014361 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Dalphond Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 W State St, North Judson, IN 46366 Phone: 574-896-5533 Fax: 574-896-5218 | |
Family Health Specialists Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 414 Lane St, North Judson, IN 46366 Phone: 574-896-3444 Fax: 574-896-3435 |