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Organization
GRAND HEART, LLC
Active
Organization
GRAND HEART, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD BONHOMME MD (OWNER)
(414) 429-2125
Entity
Organization
Contact information
Practice address
2605 N LEBANON ST, LEBANON, IN 46052-1476
(414) 429-5125
Mailing address
5235 WASHINGTON BLVD, INDIANAPOLIS, IN 46220-3060
(414) 429-2125
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
—
Other
Enumeration date
12/19/2023
Last updated
12/20/2023
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