Icp Ppo, Llc

LBN: Icp Ppo, Llc
Icp Ppo, Llc is an health care organization with primary practice located at 211 N Eddy St , South Bend IN 46617-2808. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Managed Care Organizations / Preferred Provider Organization. Managed Care Organizations / Preferred Provider Organization is the primary health care specialty. Icp Ppo, Llc can be contacted via phone (574) 234-8161, or through Macken - Marble, Kelly via phone (218) 393-1566.

Contact Information

Primary practice address
211 N Eddy St South Bend IN 46617-2808
Phone: (574) 234-8161
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Macken - Marble, Kelly
Phone: (218) 393-1566

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X
Managed Care Organizations / Preferred Provider Organization 305R00000X

Profile Details

NPI number 1407443617
LBN Legal business name Icp Ppo, Llc
DBA Doing business as
Authorized official Macken - Marble, Kelly
Entity Organization
Organization subpart 1 No
Enumeration date Dec 22nd, 2020
Last updated Dec 22nd, 2020 - about 4 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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