Healthcare Provider Details

I. General information

NPI: 1164939062
Provider Name (Legal Business Name): UNITY HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2018
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 W DIVISION STREET
REMINGTON IN
47977
US

IV. Provider business mailing address

PO BOX 4699
LAFAYETTE IN
47903-4699
US

V. Phone/Fax

Practice location:
  • Phone: 765-807-2773
  • Fax: 765-807-2774
Mailing address:
  • Phone: 765-446-5417
  • Fax: 765-446-5317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateIN

VIII. Authorized Official

Name: HEATHER DAWSON
Title or Position: DIR OF BILLING
Credential:
Phone: 765-446-5417