| Shalom 56th Street-new Access Point | |
|
5750 W 56th St Indianapolis IN 46254-1695 | |
| (317) 291-7422 | |
| (317) 291-4912 |
| Full Name | Shalom 56th Street-new Access Point |
|---|---|
| Speciality | Clinic/Center |
| Location | 5750 W 56th St, Indianapolis, Indiana |
| Authorized Official Name and Position | Leonardo R Ortega (CEO/EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3172917422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shalom 56th Street-new Access Point 3400 Lafayette Rd Ste 200 Indianapolis IN 46222-1147 Ph: (317) 291-7422 | Shalom 56th Street-new Access Point 5750 W 56th St Indianapolis IN 46254-1695 Ph: (317) 291-7422 |
| NPI Number | 1003275512 |
|---|---|
| Provider Enumeration Date | 02/12/2016 |
| Last Update Date | 01/22/2021 |
| Medicare PECOS PAC ID | 3779471750 |
|---|---|
| Medicare Enrollment ID | O20160215000849 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003275512 | NPI | - | NPPES |
| 200392480J | Medicaid | IN | |
| 200392480 | Medicaid | IN |
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