Provider Demographics
NPI:1942074646
Name:CARE ACCESS CLINIC & LAB
Entity type:Organization
Organization Name:CARE ACCESS CLINIC & LAB
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:F
Authorized Official - Last Name:FRAIS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:317-985-9335
Mailing Address - Street 1:3008 E 56TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-2946
Mailing Address - Country:US
Mailing Address - Phone:317-602-2333
Mailing Address - Fax:317-754-0617
Practice Address - Street 1:3008 E 56TH ST STE B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-2946
Practice Address - Country:US
Practice Address - Phone:317-602-2333
Practice Address - Fax:317-754-0617
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE ACCESS CLINICAL LABORATORY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-13
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty