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Organization

MERIDIAN HEALTH SERVICES CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KIRK SHAFER (C.F.O. / V.P.)
(765) 288-1928
Entity
Organization

Contact information

Practice address
205 N TILLOTSON AVE, ROOM REHAB, MUNCIE, IN 47304-3900
(765) 288-1928
(765) 741-0362
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
(765) 741-0362

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
225100000X
Physical Therapist
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201205450
IN
Enumeration date
04/15/2014
Last updated
07/20/2016
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