| Calvary Assembly Of God | |
|
1317 15th St. Se Demotte IN 46310-9393 | |
| (219) 987-4280 | |
| Not Available |
| Full Name | Calvary Assembly Of God |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1317 15th St. Se, Demotte, Indiana |
| Authorized Official Name and Position | James Clark (PRESIDENT) |
| Authorized Official Contact | 2199874280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Calvary Assembly Of God 1317 15th St Se Demotte IN 46310 Ph: (219) 987-4280 | Calvary Assembly Of God 1317 15th St. Se Demotte IN 46310-9393 Ph: (219) 987-4280 |
| NPI Number | 1306453626 |
|---|---|
| Provider Enumeration Date | 09/30/2020 |
| Last Update Date | 02/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306453626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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