Organization · NPI-2

219 Health Network, INC.

Clinic/Center, Federally Qualified Health Center (FQHC) · Munster, IN

NPI number1013581123
StatusActive
Last updated in NPPESAug 16, 2024

Details

NPI
1013581123
Entity type
Organization (NPI-2)
Legal business name
219 Health Network, INC.
Organization subpart
No
Enumeration date
May 14, 2021
Certification date
Aug 16, 2024
Last updated
Aug 16, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC)––Yes
207R00000X Internal Medicine––

Practice location

9130 Columbia Ave Ste A
Munster, IN 46321-2932

Phone 219-554-4081 · Fax 219-554-4088

Mailing address

100 W Chicago Ave Ste F
East Chicago, IN 46312-3261

Phone 219-392-7016 · Fax 219-397-6904

Authorized official

William Cortes
Executive Director
2197032585

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