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Organization

BOLDAGE PACE INDIANA LLC

Active
Other names
Heartland PACE
Organization subpart
No

Provider details

NPI number
Authorized official
MICHEAL Y CZERMAK (CAO)
(732) 608-1975
Entity
Organization

Contact information

Practice address
700 E WALNUT ST, EVANSVILLE, IN 47713-2561
(732) 806-3223
(732) 806-3323
Mailing address
106 W MOORE AVE, SUITE A, MOORESVILLE, NC 28115
(732) 806-3223

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary

Other

Enumeration date
04/24/2023
Last updated
09/02/2025
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