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INDIANA HEALTH CENTERS INC. NPI 1174626014


NPI Information

NPI: 1174626014
Provider Name: INDIANA HEALTH CENTERS, INC.

Other Name: INDIANA HEALTH CENTER @ SOUTH BEND

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1901 #B WESTERN AVE
SOUTH BEND, IN
ZIP 46619
Phone: (574) 234-9033
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INDIANA HEALTH CENTERS, INC. is a family medicine in South Bend, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. INDIANA HEALTH CENTERS, INC. NPI is 1174626014. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Indiana Health Center @ South Bend.

The provider's business location address is:

1901 #B WESTERN AVE
SOUTH BEND, IN
ZIP 46619
Phone: (574) 234-9033
Fax: (574) 234-9059

The provider's authorized official is Terrance J Drake .
The authorized official title is Chief Medical Officer (cmo) and has the following contact phone number (317) 576-1335.

The enumeration date for this NPI number is 9/6/2006 and was last updated on 12/2/2009.


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
1122300000XDentistNo
2207R00000XInternal MedicineNo
3208000000XPediatricsNo
4207Q00000XFamily MedicineYes

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
115-1806MEDICARE ID-TYPE UNSPECIFIEDINDIANAMEDICARE GROUP NUMBER
2100071250 CMEDICAIDINDIANA

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: 11/14/2023

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