| Flourishington LLC | |
|
7304 Combine Dr Lafayette IN 47905-9542 | |
| (765) 209-8193 | |
| Not Available |
| Full Name | Flourishington LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 7304 Combine Dr, Lafayette, Indiana |
| Authorized Official Name and Position | David Olatunbosun Fowope (CEO) |
| Authorized Official Contact | 7652098193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Flourishington LLC 7304 Combine Dr Lafayette IN 47905-9542 Ph: (765) 209-8193 | Flourishington LLC 7304 Combine Dr Lafayette IN 47905-9542 Ph: (765) 209-8193 |
| NPI Number | 1619840899 |
|---|---|
| Provider Enumeration Date | 09/24/2025 |
| Last Update Date | 12/28/2025 |
| Certification Date | 12/28/2025 |
| Medicare PECOS PAC ID | 5890280382 |
|---|---|
| Medicare Enrollment ID | O20251222003068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619840899 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Secondary |
| Provider Name | David Olatunbosun Fowope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871485359 PECOS PAC ID: 6709371297 Enrollment ID: I20251222003122 |
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