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Contact Information

INDIANA UNIVERSITY SOUTH BEND HEALTH & WELLNESS CENTER
941 20TH STREET
SOUTH BEND, IN46634-7111
 Phone: 574-520-5557
 Fax: 574-520-5042
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Health Maintenance Organization

302R00000X
 

Licensed Practical Nurse

164W00000X
Indicates primary specialty

NPI Profile & details for INDIANA UNIVERSITY SOUTH BEND HEALTH & WELLNESS CENTER

NPI Number 1952721185
LBN Legal business name INDIANA UNIVERSITY SOUTH BEND HEALTH & WELLNESS CENTER
Authorized official MARIO ORTIZ - (DEAN AND PROFESSOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/28/2014
Last updated 04/28/2014 - About 12 years ago
Identifiers
IN License # 01046709
IN License # 28076706A
IN License # 28156667A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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