Organization
MERIDIAN HEALTH SERVICES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK SHAFER (CFO)
(765) 288-1928
Entity
Organization
Contact information
Practice address
110 E WYSOR ST, MUNCIE, IN 47305-1724
(765) 288-1928
(765) 741-0335
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
(765) 741-0335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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