| Regional Community Health Center- Homeless Site | |
|
527 State St Hammond IN 46320-1533 | |
| (219) 803-7252 | |
| (219) 937-3300 |
| Full Name | Regional Community Health Center- Homeless Site |
|---|---|
| Speciality | Clinic/Center |
| Location | 527 State St, Hammond, Indiana |
| Authorized Official Name and Position | Bob Krumwied (CEO) |
| Authorized Official Contact | 2197694005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regional Community Health Center- Homeless Site 8400 Louisiana St Merrillville IN 46410-6385 Ph: (219) 757-1928 | Regional Community Health Center- Homeless Site 527 State St Hammond IN 46320-1533 Ph: (219) 803-7252 |
| NPI Number | 1508297540 |
|---|---|
| Provider Enumeration Date | 12/02/2013 |
| Last Update Date | 05/08/2014 |
| Medicare PECOS PAC ID | 5991600355 |
|---|---|
| Medicare Enrollment ID | O20140219001510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508297540 | NPI | - | NPPES |
| 2012166480A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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