Organization
THE SOUTH BEND CLINIC LLC
Active
Other names
The South Bend Clinic New Carlisle
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYNN HILER (CREDENTIALING COORDINATOR)
(574) 239-1567
Entity
Organization
Contact information
Practice address
8984 E US HIGHWAY 20, NEW CARLISLE, IN 46552-9038
(574) 654-8490
Mailing address
6301 UNIVERSITY COMMONS STE 230, SOUTH BEND, IN 46635-1590
(574) 239-1567
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/30/2021
Last updated
03/22/2022
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