RAPHAEL HEALTH CENTER INC NPI 1487764759

NPI Information

RAPHAEL HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Indianapolis, IN. RAPHAEL HEALTH CENTER, INC NPI is 1487764759. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

401 E 34TH ST
INDIANAPOLIS, IN
ZIP 46205
Phone: (317) 926-1507
Fax: (317) 926-1508

The provider's authorized official is Hoagland C. Elliott .
The authorized official title is Executive Director and has the following contact phone number (317) 926-1507.

The CLIA number assigned to this NPI record is 15D0920328 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 7/26/2018.

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:

Other Identifiers

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

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