Elkhart Clinic, Llc

LBN: Elkhart Clinic, Llc
Elkhart Clinic, Llc is an health care organization with primary practice located at 1904 Lake Ave , Plymouth IN 46563-7828. 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) 296-3200, or through Boyer, Kevin R. via phone (574) 296-3200.

Contact Information

Primary practice address
1904 Lake Ave Plymouth IN 46563-7828
Phone: (574) 296-3200
Fax: (574) 296-3392
Website:
Map and Directions
Authorized official contact:
Name: Boyer, Kevin R.
Phone: (574) 296-3200

Health care specialties

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

Profile Details

NPI number 1821329723
LBN Legal business name Elkhart Clinic, Llc
DBA Doing business as
Authorized official Boyer, Kevin R.
Entity Organization
Organization subpart 1 No
Enumeration date Jan 18th, 2010
Last updated May 9th, 2014 - about 11 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 1821329723 NPPES
Indiana Other 0359310001 DMERC
Indiana Other CJ0814 DMERC
Indiana MEDICAID 100466600F DMERC

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