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General NPI Number Information
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NPI Number | 1831448745
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Entity Type | Organization
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Legal Business Name | PLANNED PARENTHOOD OF INDIANA ELKHART
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 505 S. THIRD ST., SUITE 160
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City | ELKHART
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State | IN
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Zip | 46516
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Country | US
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Telephone | 574-294-7561
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Fax | 574-293-5479
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Provider Business Mailing Address
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Address Line | 200 S. MERIDIAN ST. SUITE 400
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City | INDIANAPOLIS
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State | IN
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Zip | 46225
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Country | US
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Telephone | 317-637-4343
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Fax | 317-637-4344
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Authorized Official
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Title or Position | VICE PRESIDENT, FINANCE & ADMINISTR
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Name | MS. SUZANNAH WILSON OVERHOLT
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Credential | J.D.
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Telephone | 317-637-4166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number | 01041899A
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License Number State | IN
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