Organization
INDIANA HEALTH CENTERS, INC.
Active
Other names
Indiana Health Centers @ Kokomo
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRACY NAGEL (CHIEF FINANCIAL OFFICER)
(317) 576-1335
Entity
Organization
Contact information
Practice address
3118 S LAFOUNTAIN ST, KOKOMO, IN 46902-3710
(765) 864-4160
(765) 400-4467
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1335
(317) 576-1339
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100071250 A
—
IN
Enumeration date
08/30/2006
Last updated
03/17/2023
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