Organization
NES INDIANA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT MORRA (PRESIDENT/CEO)
(800) 377-8721
Entity
Organization
Contact information
Practice address
1101 MICHIGAN AVENUE, LOGANSPORT MEMORIAL HOSPITAL, LOGANSPORT, IN 46947-7013
(574) 753-7541
(574) 753-1515
Mailing address
PO BOX 409235, ATLANTA, GA 30384-9235
(800) 377-8721
(304) 523-2241
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000232537
BCBS GROUP NUMBER
IN
Enumeration date
11/11/2005
Last updated
08/22/2020
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