| Meridian Health Services Corp. | |
|
2622 Lake Ave Ste 1 Fort Wayne IN 46805-5410 | |
| (765) 288-1928 | |
| Not Available |
| Full Name | Meridian Health Services Corp. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2622 Lake Ave Ste 1, Fort Wayne, Indiana |
| Authorized Official Name and Position | Gary Gates (REVENUE CYCLE MANAGER) |
| Authorized Official Contact | 7652542685 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meridian Health Services Corp. 240 N Tillotson Ave Muncie IN 47304-3988 Ph: (765) 288-1928 | Meridian Health Services Corp. 2622 Lake Ave Ste 1 Fort Wayne IN 46805-5410 Ph: (765) 288-1928 |
| NPI Number | 1568192458 |
|---|---|
| Provider Enumeration Date | 06/14/2022 |
| Last Update Date | 06/14/2022 |
| Medicare PECOS PAC ID | 5597679845 |
|---|---|
| Medicare Enrollment ID | O20220630000205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568192458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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