Organization
PEDIATRIC HEALTHCARE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLANCA SUAREZ (BILLER)
(219) 922-9150
Entity
Organization
Contact information
Practice address
3145 45TH ST, HIGHLAND, IN 46322-3291
(219) 922-9150
(219) 922-9180
Mailing address
3145 45TH ST, HIGHLAND, IN 46322-3291
(219) 922-9150
(219) 922-9180
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
01046288A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200135930
—
IN
Enumeration date
02/02/2009
Last updated
02/02/2009
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