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Organization

MERIDIAN HEALTH SERVICES CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KIRK W SHAFER (C.F.O.)
(765) 288-1928
Entity
Organization

Contact information

Practice address
3620 W WHITE RIVER BLVD, SUITE 2, MUNCIE, IN 47304-4286
(765) 288-1928
(765) 741-0310
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
(765) 741-0310

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200978580
IN
Enumeration date
05/16/2012
Last updated
07/20/2016
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