| Heart City Health Center Scenic Health | |
|
148 W Hively Ave Suite 1 Elkhart IN 46517-2191 | |
| (574) 584-7373 | |
| (574) 970-3255 |
| Full Name | Heart City Health Center Scenic Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 148 W Hively Ave, Elkhart, Indiana |
| Authorized Official Name and Position | Esleen E Fultz (CEO) |
| Authorized Official Contact | 5749703257 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heart City Health Center Scenic Health 236 Simpson Ave Elkhart IN 46516-4666 Ph: (574) 584-7373 | Heart City Health Center Scenic Health 148 W Hively Ave Suite 1 Elkhart IN 46517-2191 Ph: (574) 584-7373 |
| NPI Number | 1295143774 |
|---|---|
| Provider Enumeration Date | 07/28/2014 |
| Last Update Date | 11/03/2023 |
| Medicare PECOS PAC ID | 9931008380 |
|---|---|
| Medicare Enrollment ID | O20141212000849 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295143774 | NPI | - | NPPES |
| 10097610A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Heart City Health Center Pharmacy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-970-1441 Fax: 574-970-1449 | |
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Beacon Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1506 Osolo Rd Ste C, Elkhart, IN 46514 Phone: 574-266-6050 Fax: 574-262-8485 | |
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