| Trustees Of Purdue University | |
|
901 Prince William Rd Suite A Delphi IN 46923-1759 | |
| (765) 564-3016 | |
| (765) 564-2608 |
| Full Name | Trustees Of Purdue University |
|---|---|
| Speciality | Clinic/Center |
| Location | 901 Prince William Rd, Delphi, Indiana |
| Authorized Official Name and Position | Daniel J. Layman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7655643016 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trustees Of Purdue University 901 Prince William Rd Ste A Delphi IN 46923-1759 Ph: (765) 564-3016 | Trustees Of Purdue University 901 Prince William Rd Suite A Delphi IN 46923-1759 Ph: (765) 564-3016 |
| NPI Number | 1477549731 |
|---|---|
| Provider Enumeration Date | 09/22/2005 |
| Last Update Date | 07/12/2024 |
| Certification Date | 07/12/2024 |
| Medicare PECOS PAC ID | 2567373012 |
|---|---|
| Medicare Enrollment ID | O20100208000590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477549731 | NPI | - | NPPES |
| 200233610A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Indiana) | Primary |