Organization
INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL INC
Active
Other names
Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. G THOR THORDARSON (PRESIDENT/CEO)
(219) 326-2555
Entity
Organization
Contact information
Practice address
400 TEEGARDEN ST, LA PORTE, IN 46350-3175
(219) 326-0043
Mailing address
1007 LINCOLNWAY, PO BOX 250, LA PORTE, IN 46350-3201
(219) 326-2403
(219) 326-2385
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100269120B
—
IN
Enumeration date
12/30/2008
Last updated
09/16/2013
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