| Activate Healthcare - Waste Away Group | |
|
1621 W Beardsley Ave Elkhart IN 46514-1825 | |
| (773) 697-3144 | |
| Not Available |
| Full Name | Activate Healthcare - Waste Away Group |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1621 W Beardsley Ave, Elkhart, Indiana |
| Authorized Official Name and Position | Jill Johnson Patton (DIRECTOR OF RISK MANAGEMENT) |
| Authorized Official Contact | 7049365546 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Activate Healthcare - Waste Away Group 4651 Charlotte Park Dr Ste 300 Charlotte NC 28217-1916 Ph: () - | Activate Healthcare - Waste Away Group 1621 W Beardsley Ave Elkhart IN 46514-1825 Ph: (773) 697-3144 |
| NPI Number | 1093360059 |
|---|---|
| Provider Enumeration Date | 08/07/2019 |
| Last Update Date | 07/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093360059 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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