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Organization

PHYSICIAN MANAGEMENT SERVICES OF INDIANA II, LLC

Active
Parent organization
VAXCARE CORPORATION
Organization subpart
Yes

Provider details

NPI number
Legal business name
VAXCARE CORPORATION
Authorized official
BRETT KENEFICK (PRESIDENT)
(888) 829-8550
Entity
Organization

Contact information

Practice address
300 S SAINT LOUIS BLVD STE 204, SOUTH BEND, IN 46617-3044
(888) 829-8550
Mailing address
3113 LAWTON RD STE 250, ORLANDO, FL 32803-3517

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
04/28/2021
Last updated
04/28/2021
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