National Provider Identifier Database

ICP PPO LLC
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

ICP PPO, LLC
211 N EDDY ST
SOUTH BEND, IN46617-2808
Phone: 574-234-8161
Fax:
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X
Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for ICP PPO, LLC

NPI Number 1407443617
Legal business name
LBN
ICP PPO, LLC
Authorized official KELLY MACKEN - MARBLE - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 12/22/2020
Last updated 12/22/2020 - About 5 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for ICP PPO, LLC

There are currently no reviews for ICP PPO, LLC


NPIdb - Home
v2.201