Provider Demographics
NPI:1487974390
Name:EAST CENTRAL INDIANA PRIMARY CARE NETWORK
Entity type:Organization
Organization Name:EAST CENTRAL INDIANA PRIMARY CARE NETWORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:L
Authorized Official - Last Name:VANGETS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-751-3311
Mailing Address - Street 1:120 N TILLOTSON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-3987
Mailing Address - Country:US
Mailing Address - Phone:765-751-3150
Mailing Address - Fax:765-751-3155
Practice Address - Street 1:215 S HUTCHINSON AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-4774
Practice Address - Country:US
Practice Address - Phone:765-821-6920
Practice Address - Fax:765-284-6151
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHCARE CONNECTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty