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NPI Code Detail

MEDICARE: HEALTHCARE CENTERS OF INDIANA, LLC

MEDICARE: HEALTHCARE CENTERS OF INDIANA, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility05000537-2IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003029240
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHCARE CENTERS OF INDIANA, LLC
Provider Business Mailing Address
First Line : 300 GLEED AVE
Second Line :
City : EAST AURORA
State : NY
Zip : 14052-2983
Country : US
Telephone Number : 716-652-2820
Fax Number : 716-655-2320
Provider Business Practice Location Address
First Line : 3895 S KEYSTONE AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-3540
Country : US
Telephone Number : 317-787-5364
Fax Number : 317-788-3962
Authorized Official
Title or Position : VICE PRESIDENT
Name : MRS. JOY A FELDMAN
Credential :
Telephone Number : 716-805-1474
Provider Enumeration Date : 05/07/2007
Last Update Date : 03/17/2009

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Directions to “HEALTHCARE CENTERS OF INDIANA, LLC ” Practice Location

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