| Silver Moon Llc | |
|
9801 Fall Creek Rd #124 Indianapolis IN 46256-4802 | |
| (317) 413-0119 | |
| Not Available |
| Full Name | Silver Moon Llc |
|---|---|
| Speciality | Social Worker |
| Location | 9801 Fall Creek Rd, Indianapolis, Indiana |
| Authorized Official Name and Position | Elizabeth Farr (PRESIDENT) |
| Authorized Official Contact | 3174130119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Silver Moon Llc 9801 Fall Creek Rd #124 Indianapolis IN 46256-4802 Ph: (317) 413-0119 | Silver Moon Llc 9801 Fall Creek Rd #124 Indianapolis IN 46256-4802 Ph: (317) 413-0119 |
| NPI Number | 1104197789 |
|---|---|
| Provider Enumeration Date | 01/13/2012 |
| Last Update Date | 02/16/2012 |
| Medicare PECOS PAC ID | 8820257157 |
|---|---|
| Medicare Enrollment ID | O20120306000854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104197789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34006405A (Indiana) | Primary |
| Provider Name | Elizabeth M Drucker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669743894 PECOS PAC ID: 9739348061 Enrollment ID: I20120306000904 |
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