| Fundamental Health, Inc | |
|
1221 S Creasy Ln Ste K3 Lafayette IN 47905-7430 | |
| (765) 838-2310 | |
| (765) 838-1035 |
| Full Name | Fundamental Health, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1221 S Creasy Ln Ste K3, Lafayette, Indiana |
| Authorized Official Name and Position | Julie Christine Miranda (PRACTICE MANAGER) |
| Authorized Official Contact | 7658382310 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fundamental Health, Inc 1221 S Creasy Ln Ste K3 Lafayette IN 47905-7430 Ph: (765) 838-2310 | Fundamental Health, Inc 1221 S Creasy Ln Ste K3 Lafayette IN 47905-7430 Ph: (765) 838-2310 |
| NPI Number | 1114529237 |
|---|---|
| Provider Enumeration Date | 11/13/2020 |
| Last Update Date | 02/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114529237 | NPI | - | NPPES |
| 1942753082 | Other | IN | NPI |
| 1114529237 | Other | IN | MEN'S HEALTH |
| 1659312759 | Other | IN | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Secondary |
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