| Knox Winamac Community Health Centers, Inc | |
|
1520 S Heaton St Knox IN 46534-2393 | |
| (574) 772-2188 | |
| (574) 772-2190 |
| Full Name | Knox Winamac Community Health Centers, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1520 S Heaton St, Knox, Indiana |
| Authorized Official Name and Position | Diana R Fritz (OFFICE MANAGER) |
| Authorized Official Contact | 5747722188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Knox Winamac Community Health Centers, Inc 1520 S Heaton St Knox IN 46534-2393 Ph: (574) 772-2188 | Knox Winamac Community Health Centers, Inc 1520 S Heaton St Knox IN 46534-2393 Ph: (574) 772-2188 |
| NPI Number | 1619921558 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 04/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619921558 | NPI | - | NPPES |
| 000000083056 | Other | IN | BLUE CROSS BLUE SHIELD |
| 200020860A | Medicaid | IN | |
| 50000720A | Other | IN | CORPORATION LICENSE |
| 200897290 | Medicaid | IN | |
| 100225090 | Medicaid | IN | |
| 351301967 | Other | IN | TAX ID |
| 01024309A | Other | IN | WALTER FRITZ, M.D. LICENS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 50000720A (Indiana) | Secondary |
| 207Q00000X | Family Medicine | 50000720A (Indiana) | Primary |
A.n. Damodaran, M.d. Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 S Pearl St, Knox, IN 46534 Phone: 574-207-5050 Fax: 574-207-5002 | |
Knox Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1520 S Heaton St, Knox, IN 46534 Phone: 574-772-2188 Fax: 574-772-2190 | |
Theresa M. Alexander Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1006 S Edgewood Dr, Knox, IN 46534 Phone: 574-772-5505 Fax: 574-772-6151 | |
Laporte Regional Physician Network, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 S Heaton, Knox, IN 46534 Phone: 574-772-3187 Fax: 574-772-4843 | |
Robert R Cornwell Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 S Heaton St, Knox, IN 46534 Phone: 574-772-7300 Fax: 574-772-7301 | |
Pulaski Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2 S Pearl St, Knox, IN 46534 Phone: 574-207-5050 | |
Knox Winamac Community Health Centers, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 S Edgewood Dr, Knox, IN 46534 Phone: 574-772-6030 Fax: 574-772-7494 |