| Premise Health Of Indiana Medical, P.c. | |
|
750 E Middlebury St Shipshewana IN 46565-8801 | |
| (260) 768-7411 | |
| Not Available |
| Full Name | Premise Health Of Indiana Medical, P.c. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 750 E Middlebury St, Shipshewana, Indiana |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Indiana Medical, P.c. 5500 Maryland Way Brentwood TN 37027-7048 Ph: () - | Premise Health Of Indiana Medical, P.c. 750 E Middlebury St Shipshewana IN 46565-8801 Ph: (260) 768-7411 |
| NPI Number | 1477226454 |
|---|---|
| Provider Enumeration Date | 07/27/2021 |
| Last Update Date | 08/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477226454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Community Medical Center Of Shipshewana Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S Van Buren St, Shipshewana, IN 46565 Phone: 260-768-4182 Fax: 260-768-4357 |