Fundamental Health, Inc | |
1221 S Creasy Ln Ste K3 Lafayette IN 47905-7430 | |
(765) 838-2310 | |
(765) 838-1035 |
Full Name | Fundamental Health, Inc |
---|---|
Speciality | Internal Medicine |
Location | 1221 S Creasy Ln Ste K3, Lafayette, Indiana |
Authorized Official Name and Position | Julie Christine Miranda (PRACTICE MANAGER) |
Authorized Official Contact | 7658382310 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Fundamental Health, Inc 1221 S Creasy Ln Ste K3 Lafayette IN 47905-7430 Ph: (765) 838-2310 | Fundamental Health, Inc 1221 S Creasy Ln Ste K3 Lafayette IN 47905-7430 Ph: (765) 838-2310 |
NPI Number | 1114529237 |
---|---|
Provider Enumeration Date | 11/13/2020 |
Last Update Date | 02/26/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114529237 | NPI | - | NPPES |
1942753082 | Other | IN | NPI |
1114529237 | Other | IN | MEN'S HEALTH |
1659312759 | Other | IN | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Secondary |
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