MEDICARE: MOBILE HEALTH CARE, INC

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
1	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	XF200506	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00168382	OTHER	IN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000175431	OTHER	IN	ANTHEM BLUE CROSS & BLUE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	630000140	OTHER	IN	UNITED HEALTH CARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326012873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	4511 N JOHNSON RD
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-7675
Country	:	US
Telephone Number	:	219-872-7799
Fax Number	:	219-872-8060

Provider Business Practice Location Address
First Line	:	4511 N JOHNSON RD
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-7675
Country	:	US
Telephone Number	:	219-872-7799
Fax Number	:	219-872-8060

Authorized Official
Title or Position	:	OWNER
Name	:	MR. CARL F. WIPPERMAN
Credential	:	RT
Telephone Number	:	219-872-7799

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	03/17/2009

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Directions to “MOBILE HEALTH CARE, INC ” Practice Location

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