| Iroquois Memorial Hospital And Resident Home | |
|
303 N 7th St Kentland IN 47951-1379 | |
| (219) 474-5464 | |
| (219) 474-3603 |
| Full Name | Iroquois Memorial Hospital And Resident Home |
|---|---|
| Speciality | Clinic/Center |
| Location | 303 N 7th St, Kentland, Indiana |
| Authorized Official Name and Position | Timothy L Smith (COO) |
| Authorized Official Contact | 81584327967 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iroquois Memorial Hospital And Resident Home 303 N 7th St Kentland IN 47951-1379 Ph: (219) 474-5464 | Iroquois Memorial Hospital And Resident Home 303 N 7th St Kentland IN 47951-1379 Ph: (219) 474-5464 |
| NPI Number | 1467470906 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 01/17/2017 |
| Medicare PECOS PAC ID | 4385551258 |
|---|---|
| Medicare Enrollment ID | O20100624000397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467470906 | NPI | - | NPPES |
| 200133940A | Medicaid | IN | |
| 0003815082 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Proactive Mso, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13188 S 50 E, Kentland, IN 47951 Phone: 812-645-1892 |