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NORTHERN INDIANA MATERNAL AND CHILD HEALTH NETWORK INC NPI 1528151602


NPI Information

NPI: 1528151602
Provider Name: NORTHERN INDIANA MATERNAL AND CHILD HEALTH NETWORK, INC
Classification: Clinic/Center - 261QA0005X
Entity Type: Organization

Specialization: Ambulatory Family Planning Facility

CLIA Number: 15D1054359

Address:
244 S OLIVE ST
SUITE E
SOUTH BEND, IN
ZIP 46619
Phone: (574) 282-3230
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NORTHERN INDIANA MATERNAL AND CHILD HEALTH NETWORK, INC is an ambulatory family planning facility clinic center in South Bend, IN. The provider is an abortion/family planning facility where services are provided at a fixed specific location. An Ambulatory Family Planning Facility does not provide overnight accommodations. The following procedures may be performed at an Ambulatory Family Planning Facility: abortions, laproscopy, hysterectomies, tubule ligation and other related procedures. Abortion is considered voluntary termination of pregnancy. NORTHERN INDIANA MATERNAL AND CHILD HEALTH NETWORK, INC NPI is 1528151602. The provider is registered as an organization entity type.

The provider's business location address is:

244 S OLIVE ST
SUITE E
SOUTH BEND, IN
ZIP 46619-106
Phone: (574) 282-3230
Fax: (574) 282-3240

The provider's authorized official is Melinda M Konrath .
The authorized official title is Executive Director and has the following contact phone number (574) 282-3230.

The CLIA number assigned to this NPI record is 15D1054359 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/2/2006 and was last updated on 6/10/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251K00000XPublic Health or Welfare200817480AINDIANANo
2261QA0005XClinic/CenterAmbulatory Family Planning Facility200817480BINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200817480BMEDICAIDINDIANA
2200817480AMEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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