Organization
MEMORIAL HEALTH SYSTEM, INC.
Active
Other names
LaPorte PT
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY COSTELLO (VP-CFO)
(574) 647-3549
Entity
Organization
Contact information
Practice address
900 I ST, LA PORTE, IN 46350-5533
(219) 324-1700
Mailing address
328 N MICHIGAN ST, SUITE 200, SOUTH BEND, IN 46601-1244
(574) 647-1069
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000178974
ANTHEM
IN
Enumeration date
04/17/2007
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up