Organization
MEMORIAL HEALTH SYSTEM, INC.
Active
Organization
MEMORIAL HEALTH SYSTEM, INC.
Active
Other names
Heart Specialists PC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY P. COSTELLO (VP/CFO)
(574) 647-3549
Entity
Organization
Contact information
Practice address
621 MEMORIAL DR, SUITE 608, SOUTH BEND, IN 46601-1063
(574) 232-3522
(574) 232-3526
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01043726A
IN
Other
Enumeration date
06/10/2006
Last updated
08/30/2016
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