Organization
INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL INC
Active
Other names
LaPorte Occupational Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
G THOR THORDARSON (PRESIDENT/CEO)
(219) 326-2555
Entity
Organization
Contact information
Practice address
311 BOYD BLVD, LA PORTE, IN 46350-3965
(219) 326-2664
(219) 325-5435
Mailing address
311 BOYD BLVD, LA PORTE, IN 46350-3965
(219) 326-2664
(219) 325-5435
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
09-005006-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097783
ANTHEM
IN
05
—
100269110
—
IN
05
—
110269120
—
IN
05
—
700339
—
IN
Enumeration date
11/03/2006
Last updated
09/16/2013
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