NPI 1073680419

The South Bend Clinic LLC

Organisation Clinic/Center South Bend, IN

Practice location

Address: 211 N Eddy St, South Bend, IN 46617-2808
Phone: (574) 299-2450
Fax: (574) 299-2415
Mailing address: 6301 University Commons STE 230, South Bend, IN 46635-1590

Authorised official

Name: Paul J Meyer
Title: Executive Director
Phone: (574) 237-9201

Registered specialties (4)

Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261Q00000X

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Ambulatory Surgical Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QA1903X

Clinical Medical Laboratory

Laboratories Taxonomy 291U00000X Licence 15D0357414 (IN)

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Durable Medical Equipment & Medical Supplies

Suppliers Taxonomy 332B00000X

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Registry record

NPI: 1073680419
Entity type: Organization
NPI issued: 29 Nov 2006
Record last updated: 10 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.