| Tca Health Inc Nfp | |
|
5504 Hohman Ave Hammond IN 46320-1933 | |
| (773) 995-6300 | |
| (773) 995-7985 |
| Full Name | Tca Health Inc Nfp |
|---|---|
| Speciality | Clinic/Center |
| Location | 5504 Hohman Ave, Hammond, Indiana |
| Authorized Official Name and Position | Veronica Clarke (CEO) |
| Authorized Official Contact | 7739951940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tca Health Inc Nfp 1029 E 130th St Chicago IL 60628-6908 Ph: (773) 995-6300 | Tca Health Inc Nfp 5504 Hohman Ave Hammond IN 46320-1933 Ph: (773) 995-6300 |
| NPI Number | 1093404576 |
|---|---|
| Provider Enumeration Date | 05/02/2023 |
| Last Update Date | 12/03/2024 |
| Medicare PECOS PAC ID | 5991696643 |
|---|---|
| Medicare Enrollment ID | O20240827003602 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093404576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
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