NPI 1407543960

Boldage Pace Indiana LLC

Organisation PACE Provider Organization Evansville, IN

Practice location

Address: 700 E Walnut St, Evansville, IN 47713-2561
Phone: (732) 806-3223
Fax: (732) 806-3323
Mailing address: 106 W Moore Ave Suite a, Mooresville, NC 28115

Authorised official

Name: Micheal Y Czermak
Title: Cao
Phone: (732) 608-1975

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in Indiana →

Registry record

NPI: 1407543960
Entity type: Organization
NPI issued: 24 Apr 2023
Record last updated: 2 Sep 2025

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.