Edgewater Primary Care

LBN: Edgewater Systems For Balanced Living, Inc.
Edgewater Primary Care is an health care organization with primary practice located at 5495 Broadway , Merrillville IN 46410-1647. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Edgewater Systems For Balanced Living, Inc. can be contacted via phone (219) 884-4900, or through Johnson Hughes, Danita via phone (219) 885-4264.

Contact Information

Primary practice address
5495 Broadway Merrillville IN 46410-1647
Phone: (219) 884-4900
Fax: (219) 980-7585
Website:
Map and Directions
Authorized official contact:
Name: Johnson Hughes, Danita PHD.
Phone: (219) 885-4264

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01033511A Indiana

Profile Details

NPI number 1699225698
LBN Legal business name Edgewater Systems For Balanced Living, Inc.
DBA Doing business as Edgewater Primary Care
Authorized official Johnson Hughes, Danita PHD.
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 13th, 2016
Last updated May 14th, 2024 - about 4 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699225698 NPPES
Indiana MEDICAID 200030490A

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