| 360 Integrated Medical Center, Pc | |
|
2504 Monroe St La Porte IN 46350-5241 | |
| (219) 326-5100 | |
| (219) 326-0180 |
| Full Name | 360 Integrated Medical Center, Pc |
|---|---|
| Speciality | General Practice |
| Location | 2504 Monroe St, La Porte, Indiana |
| Authorized Official Name and Position | Matthew Kirkham (OWNER) |
| Authorized Official Contact | 2193265100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 360 Integrated Medical Center, Pc 2504 Monroe St La Porte IN 46350-5241 Ph: () - | 360 Integrated Medical Center, Pc 2504 Monroe St La Porte IN 46350-5241 Ph: (219) 326-5100 |
| NPI Number | 1710459458 |
|---|---|
| Provider Enumeration Date | 12/19/2018 |
| Last Update Date | 12/19/2018 |
| Medicare PECOS PAC ID | 6204265614 |
|---|---|
| Medicare Enrollment ID | O20200407000709 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710459458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Matthew C Kirkham |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1841208865 PECOS PAC ID: 7810044948 Enrollment ID: I20090407000470 |
| Provider Name | Angela M Vanderberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093019994 PECOS PAC ID: 0547441917 Enrollment ID: I20110218000567 |
| Provider Name | Katie Np O'connor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174092126 PECOS PAC ID: 8426399486 Enrollment ID: I20190401002538 |
Gregory A. Andrews, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 Lincolnway, Suite 206, La Porte, IN 46350 Phone: 219-324-3053 Fax: 219-324-5352 | |
Northshore Health Centers, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 504 Legacy Plz W, La Porte, IN 46350 Phone: 219-763-8112 Fax: 219-764-5333 | |
Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Teegarden St, La Porte, IN 46350 Phone: 219-326-0043 | |
Charles F Motley Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6916 W Johnson Rd, La Porte, IN 46350 Phone: 219-872-7247 Fax: 219-879-8609 | |
Healthlinc, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 400 Teegarden St, La Porte, IN 46350 Phone: 888-580-1060 Fax: 219-465-9507 | |
Laporte Osteopathic Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 125 East Shore Parkway, Suite D, La Porte, IN 46350 Phone: 219-325-0155 | |
La Porte Clinic Company Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1331 State St, La Porte, IN 46350 Phone: 219-344-6450 |