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 Ste A , Mishawaka IN 46545-3557. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Multi-Specialty. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty.
Elkhart Clinic,Llc can be contacted via phone (574) 252-0667, or through Boyer, Kevin R via phone (574) 296-3200.
Contact Information
Primary practice address
410 Park Pl Ste A
Mishawaka IN 46545-3557
Phone: (574) 252-0667
Fax: (574) 807-8845
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X |
Profile Details
| NPI number | 1851497945 |
|---|---|
| LBN Legal business name | Elkhart Clinic,Llc |
| DBA Doing business as | Primary Care At Mishawaka |
| Authorized official | Boyer, Kevin R |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 15th, 2006 |
| Last updated | May 8th, 2019 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851497945 | NPPES |
| Indiana | MEDICAID | 100466600 |
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