| Open Door Health Services, Inc. | |
|
2600 W White River Blvd Muncie IN 47303-5263 | |
| (765) 286-7000 | |
| Not Available |
| Full Name | Open Door Health Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2600 W White River Blvd, Muncie, Indiana |
| Authorized Official Name and Position | Bryan Ayars (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7657472971 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Door Health Services, Inc. Po Box 1676 Muncie IN 47308-1676 Ph: (765) 286-7000 | Open Door Health Services, Inc. 2600 W White River Blvd Muncie IN 47303-5263 Ph: (765) 286-7000 |
| NPI Number | 1104133511 |
|---|---|
| Provider Enumeration Date | 09/07/2010 |
| Last Update Date | 11/30/2020 |
| Medicare PECOS PAC ID | 5890696603 |
|---|---|
| Medicare Enrollment ID | O20190409002391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104133511 | NPI | - | NPPES |
| 200167970 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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