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General NPI Number Information
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NPI Number | 1588301899
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Entity Type | Organization
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Legal Business Name | PORTER-STARKE SERVICES INC.
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 3176 LANCER ST STE B
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City | PORTAGE
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State | IN
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Zip | 46368-4408
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Country | US
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Telephone | 219-806-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 601 WALL ST
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City | VALPARAISO
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State | IN
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Zip | 46383-2512
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Country | US
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Telephone | 219-531-3500
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF ADMINISTRATION
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Name | KATE SANDERS
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Credential |
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Telephone | 219-476-4664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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