Organization
PORTER HEALTH SERVICES
Active
Other names
Glendale Medical Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL HAMMOND (CFO)
(219) 364-3660
Entity
Organization
Contact information
Practice address
1101 GLENDALE BLVD, VALPARAISO, IN 46383-3767
(216) 464-0232
(219) 759-3807
Mailing address
26700 BROOKPARK ROAD EXT, SUITE 1, NORTH OLMSTED, OH 44070-3124
(800) 611-6912
(440) 716-1605
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000286384
ANTHEM
IN
Enumeration date
03/28/2006
Last updated
08/22/2020
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