| Servant Express Care, Llc | |
|
2346 S Lynhurst Dr Ste E109 Indianapolis IN 46241-5169 | |
| (317) 480-0415 | |
| Not Available |
| Full Name | Servant Express Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2346 S Lynhurst Dr Ste E109, Indianapolis, Indiana |
| Authorized Official Name and Position | Duanesha Potter (MEMBER) |
| Authorized Official Contact | 3174800415 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Servant Express Care, Llc 2346 S Lynhurst Dr Ste E109 Indianapolis IN 46241-5169 Ph: () - | Servant Express Care, Llc 2346 S Lynhurst Dr Ste E109 Indianapolis IN 46241-5169 Ph: (317) 480-0415 |
| NPI Number | 1396437141 |
|---|---|
| Provider Enumeration Date | 05/22/2023 |
| Last Update Date | 05/22/2023 |
| Medicare PECOS PAC ID | 3678932530 |
|---|---|
| Medicare Enrollment ID | O20230710003384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396437141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Duanesha Potter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487355921 PECOS PAC ID: 4587023445 Enrollment ID: I20230710003429 |
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