State Of Indiana | |
10892 N State Road 140 Knightstown IN 46148-9769 | |
(765) 345-5141 | |
(765) 345-7412 |
Full Name | State Of Indiana |
---|---|
Speciality | Clinic/center |
Location | 10892 N State Road 140, Knightstown, Indiana |
Authorized Official Name and Position | Allen Collier (ASSISTANT SUPERINTENDENT) |
Authorized Official Contact | 7653455141 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
State Of Indiana 10892 N State Road 140 Knightstown IN 46148-9769 Ph: (765) 345-5141 | State Of Indiana 10892 N State Road 140 Knightstown IN 46148-9769 Ph: (765) 345-5141 |
NPI Number | 1982873717 |
---|---|
Provider Enumeration Date | 02/26/2008 |
Last Update Date | 06/19/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982873717 | NPI | - | NPPES |
200074490 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | STATE OWNED FACILITY (Indiana) | Primary |
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Knightstown Healthcare Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 437 N Mccullum St, Knightstown, IN 46148 Phone: 765-345-5572 Fax: 317-468-6148 |