| Qualified Healthcare Llc | |
|
5555 N Tacoma Ave Ste 104 Indianapolis IN 46220-3551 | |
| (317) 426-2210 | |
| (317) 779-2560 |
| Full Name | Qualified Healthcare Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5555 N Tacoma Ave Ste 104, Indianapolis, Indiana |
| Authorized Official Name and Position | Deborah Mcglasson (PRESIDENT) |
| Authorized Official Contact | 3174262210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Qualified Healthcare Llc 5555 N Tacoma Ave Ste 104 Indianapolis IN 46220-3551 Ph: (317) 426-2210 | Qualified Healthcare Llc 5555 N Tacoma Ave Ste 104 Indianapolis IN 46220-3551 Ph: (317) 426-2210 |
| NPI Number | 1700489390 |
|---|---|
| Provider Enumeration Date | 11/17/2020 |
| Last Update Date | 11/17/2020 |
| Medicare PECOS PAC ID | 8628484235 |
|---|---|
| Medicare Enrollment ID | O20210305001586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700489390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Deborah Ann Mcglasson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598021503 PECOS PAC ID: 1759710122 Enrollment ID: I20200406002206 |
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