| The South Bend Clinic Llp | |
|
211 N Eddy St South Bend IN 46617-2808 | |
| (574) 246-8816 | |
| (574) 237-9309 |
| Full Name | The South Bend Clinic Llp |
|---|---|
| Speciality | Clinic/center |
| Location | 211 N Eddy St, South Bend, Indiana |
| Authorized Official Name and Position | Kelly E. Macken-marble (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5742379201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The South Bend Clinic Llp Po Box 715223 Cincinnati OH 45271-5223 Ph: (574) 299-2450 | The South Bend Clinic Llp 211 N Eddy St South Bend IN 46617-2808 Ph: (574) 246-8816 |
| NPI Number | 1538257167 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 01/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538257167 | NPI | - | NPPES |
| 200266980A | Medicaid | IN |
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