| |
5525 W 34th St Indianapolis IN 46224-1301 | |
(317) 880-3535 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 5525 W 34th St, Indianapolis, Indiana |
Authorized Official Name and Position | Christopher Scott (SUPERVISOR, PROVIDER ENROLLMENT) |
Authorized Official Contact | 3178804440 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
720 Eskenazi Ave Fifth Third Bank Bldg, 5th Fl Indianapolis IN 46202-5166 Ph: (317) 880-3818 | 5525 W 34th St Indianapolis IN 46224-1301 Ph: (317) 880-3535 |
NPI Number | 1366181042 |
---|---|
Provider Enumeration Date | 06/01/2022 |
Last Update Date | 09/05/2023 |
Medicare PECOS PAC ID | 6709795974 |
---|---|
Medicare Enrollment ID | O20221004000626 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366181042 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Moazzam Habib Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9240 N Meridian St, Suite 240, Indianapolis, IN 46260 Phone: 317-571-0030 Fax: 317-571-0031 | |
Franciscan Health Indianapolis & Mooresville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5230a East Stop 11 Road, Suite 250, Indianapolis, IN 46237 Phone: 317-528-8921 Fax: 317-528-6916 | |
Evernorth Care Providers - Delaware Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8888 Keystone Xing Ste 1300, Indianapolis, IN 46240 Phone: 773-292-4800 Fax: 312-564-4059 | |
Cadience Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5602 Caito Dr, Indianapolis, IN 46226 Phone: 901-235-2065 |