NPI | 1104538636 |
---|---|
Doing Business As | FOUNDATIONS FAMILY MEDICINE |
Entity Type | Organization |
Authorized Contact | CATHY SUE JARVIS Revenue Cycle Manager 765-973-9294 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2022-12-15 |
Last Update Date | 2022-12-15 |