Organization
PORTER-STARKE SERVICES INC.
Active
Other names
Marram Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
AILEEN WEHREN EDD (VICE PRESIDENT)
(219) 476-4567
Entity
Organization
Contact information
Practice address
3229 BROADWAY STE 115, GARY, IN 46409-1040
(219) 531-3500
Mailing address
601 WALL ST, VALPARAISO, IN 46383-2512
(219) 531-3500
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
151013
MEDICARE FQHC
IN
Enumeration date
08/21/2015
Last updated
07/29/2019
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