Organization
WARSAW HEALTH SYSTEM LLC
Active
Other names
Provident Family Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA HURLEY (SENIOR VICE PRESIDENT)
(214) 473-3993
Entity
Organization
Contact information
Practice address
1210 PROVIDENT DR, SUITE B, WARSAW, IN 46580-3266
(574) 372-5823
Mailing address
PO BOX 996, WARSAW, IN 46581-0996
(574) 372-5823
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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