Primary Care At Mishawaka

LBN: Elkhart Clinic, Llc
Primary Care At Mishawaka is an health care organization with primary practice located at 410 Park Pl Suite B, Mishawaka IN 46545-3557. The organization recently has only one registered license in Ambulatory Health Care Facilities / Multi-Specialty, which is considered as the primary health care specialty. Elkhart Clinic, Llc can be contacted via phone (574) 855-5800, or through Porsche, Timothy via phone (574) 296-3200.

Contact Information

Primary practice address
410 Park Pl Suite B Mishawaka IN 46545-3557
Phone: (574) 855-5800
Fax: (574) 855-5805
Website:
Map and Directions
Authorized official contact:
Name: Porsche, Timothy
Phone: (574) 296-3200

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1235303165
LBN Legal business name Elkhart Clinic, Llc
DBA Doing business as Primary Care At Mishawaka
Authorized official Porsche, Timothy
Entity Organization
Organization subpart 1 No
Enumeration date Apr 22nd, 2008
Last updated Jul 15th, 2020 - about 5 years 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 1235303165 NPPES
Indiana MEDICAID 100466600D
Indiana Other 0359310002

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