Organization
TRUSTEES OF PURDUE UNIVERSITY
Active
Parent organization
PURDUE UNIVERSITY
Other names
Family Health Clinic of Monon
Organization subpart
Yes
Provider details
NPI number
Legal business name
PURDUE UNIVERSITY
Authorized official
MR. DANIEL J LAYMAN (EXECUTIVE DIRECTOR)
(765) 564-3016
Entity
Organization
Contact information
Practice address
692 E BROADWAY ST, MONON, IN 47959-8191
(877) 797-2404
Mailing address
PO BOX 597, DELPHI, IN 46923-0597
(765) 564-3016
(765) 564-2608
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200852780A
—
IN
Enumeration date
05/29/2007
Last updated
07/12/2024
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