Healthcare Provider Details

I. General information

NPI: 1033225172
Provider Name (Legal Business Name): MUNSTER MEDICAL RESEARCH FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MACARTHUR BLVD
MUNSTER IN
46321-2901
US

IV. Provider business mailing address

PO BOX 3602
MUNSTER IN
46321-0756
US

V. Phone/Fax

Practice location:
  • Phone: 219-836-1600
  • Fax: 219-934-8889
Mailing address:
  • Phone: 219-934-8888
  • Fax: 219-934-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number050051061
License Number StateIN

VIII. Authorized Official

Name: MRS. CHAR KULLERSTRAND
Title or Position: REGIONAL DIRECTOR
Credential:
Phone: 219-934-8994