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General NPI Number Information
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NPI Number | 1629473053
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Entity Type | Organization
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Legal Business Name | MERIDIAN HEALTH SERVICES CORP
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 04/18/2019
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Provider Practice Location Address
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Address Line | 205 N TILLOTSON AVE
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City | MUNCIE
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State | IN
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Zip | 47304-3900
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Country | US
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Telephone | 765-288-1928
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Fax | 765-741-0362
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Provider Business Mailing Address
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Address Line | 240 N TILLOTSON AVE
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City | MUNCIE
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State | IN
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Zip | 47304-3988
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Country | US
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Telephone | 765-288-1928
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Fax | 765-741-0362
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Authorized Official
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Title or Position | C.F.O.
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Name | KIRK SHAFER
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Credential |
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Telephone | 765-288-1928
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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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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