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Organization

QUALITY CORRECTIONAL CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORA SORRELL (DIRECTOR)
(765) 749-5290
Entity
Organization

Contact information

Practice address
12900 N MERIDIAN ST STE 140, CARMEL, IN 46032-5401
(765) 749-5290
Mailing address
400 W AIR PARK DR, MUNCIE, IN 47303-1886
(765) 749-5290

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
363LF0000X
Family Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300097541
IN
Enumeration date
01/21/2016
Last updated
10/25/2024
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