Organization
SAINT JOHN'S HEALTH SYSTEM
Active
Other names
Pendleton Family Practice Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES W MOORE (EXECUTIVE VICE PRESIDENT)
(765) 646-8105
Entity
Organization
Contact information
Practice address
75 VILLAGE DR, PENDLETON, IN 46064-8960
(765) 778-0913
(765) 778-1374
Mailing address
75 VILLAGE DR, PENDLETON, IN 46064-8960
(765) 778-0913
(765) 778-1374
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/21/2006
Last updated
08/22/2020
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