Organization
INDIANA HEALTH CENTERS, INC
Active
Parent organization
INDIANA HEALTH CENTERS, INC
Other names
SOUTH BEND AT OAKLAWN
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDIANA HEALTH CENTERS, INC
Authorized official
MR. TRACY J NAGEL (CFO)
(317) 576-1335
Entity
Organization
Contact information
Practice address
415 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 234-9033
(574) 234-9059
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1335
(317) 576-1339
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
—
100071250
—
IN
Enumeration date
04/22/2014
Last updated
03/17/2023
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