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Organization

MEMORIAL HEALTH SYSTEM, INC.

Active
Other names
Memorial's Prenatal Clinic @ Olive Street
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFFREY P. COSTELLO (VP/CFO)
(574) 647-3549
Entity
Organization

Contact information

Practice address
244 S OLIVE ST, SUITE E, SOUTH BEND, IN 46619-2100
(574) 647-1600
(574) 237-6069
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
09000186A
IN

Other

Enumeration date
11/19/2009
Last updated
03/09/2016
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