| Gregory Lee Blair, | |
|
3903 Indianapolis Blvd, East Chicago, IN 46312-2555 | |
| (219) 398-7050 | |
| (219) 757-1950 |
| Full Name | Gregory Lee Blair |
|---|---|
| Gender | Male |
| Speciality | Counselor |
| Location | 3903 Indianapolis Blvd, East Chicago, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265576821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Entity Name | Lpa Co |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952852105 PECOS PAC ID: 7911286695 Enrollment ID: O20161121001613 |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220510002320 |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Lee Blair, 909 N Rensselaer St, Griffith, IN 46319-1622 Ph: (219) 838-4128 | Gregory Lee Blair, 3903 Indianapolis Blvd, East Chicago, IN 46312-2555 Ph: (219) 398-7050 |
Denise Polen, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3903 Indianapolis Blvd, East Chicago, IN 46312 Phone: 219-398-7050 | |
Hilda Emelogu, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3903 Indianapolis Blvd, East Chicago, IN 46312 Phone: 219-392-6001 | |
Lisa Maria Myles, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3903 Indianapolis Blvd, East Chicago, IN 46312 Phone: 219-398-7050 Fax: 219-757-1950 | |
Michelle Hardlannert, LMHC Counselor Medicare: Medicare Enrolled Practice Location: 3903 Indianapolis Blvd, East Chicago, IN 46312 Phone: 219-392-6001 | |
Raiko Watson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3903 Indianapolis Blvd, East Chicago, IN 46312 Phone: 219-392-6001 | |
Michael Christopher Mclain, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 3903 Indianapolis Blvd, East Chicago, IN 46312 Phone: 219-398-7050 Fax: 219-757-1950 | |
Paula M Minard, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3903 Indianapolis Blvd, East Chicago, IN 46312 Phone: 219-398-7050 Fax: 219-392-6998 |