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Contact Information

BROADWAY FOOT CLINIC CORPORATION
3290 GRANT ST
SUITE 108
GARY, IN46408-1015
 Phone: 219-884-7880
 Fax: 219-884-7880
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for BROADWAY FOOT CLINIC CORPORATION

NPI # 1073510244
LBN Legal business name BROADWAY FOOT CLINIC CORPORATION
Authorized official SONNY OJIKUTU - (VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/03/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
IN License # 07000445A
IN Medicaid 10058560
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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