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General NPI Number Information
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NPI Number | 1700797743
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Entity Type | Organization
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Legal Business Name | FORD ENTERPRISES LLC
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Dates
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Enumeration Date | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 2119 29TH ST
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City | BEDFORD
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State | IN
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Zip | 47421-5305
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Country | US
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Telephone | 812-675-0902
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Fax |
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Provider Business Mailing Address
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Address Line | 2119 29TH ST
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City | BEDFORD
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State | IN
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Zip | 47421-5305
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Country | US
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Telephone | 812-675-0902
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JERRY FORD
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Credential |
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Telephone | 812-278-4549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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