Organization · NPI-2

Elkhart Clinic, LLC

Clinic/Center · Elkhart, IN

NPI number1073181335
StatusActive
Last updated in NPPESJun 14, 2021

Details

NPI
1073181335
Entity type
Organization (NPI-2)
Legal business name
Elkhart Clinic, LLC
Organization subpart
No
Enumeration date
Jun 14, 2021
Certification date
Jun 14, 2021
Last updated
Jun 14, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Other names

  • Medical Oncology And Hematology At Elkhart Clinic Main (Other Name)

Practice location

2117 W Lexington Ave
Elkhart, IN 46514-1423

Phone 574-296-3444 · Fax 574-296-3328

Mailing address

Po Box 2968
Elkhart, IN 46515-2968

Phone 574-296-3200

Authorized official

Timothy Porsche
Managing Partner
5742963200

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