FORDEM HEALTH, LLC (NPI# 1639622236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639622236 |
| Entity Type | Organization |
| Organization Name | FORDEM HEALTH, LLC |
| Practice Address |
1313 Park Dr Munster IN 46321-2634 |
| Mailing Address |
730 45th Ave Munster IN 46321-2818 |
| Practice Telephone | 8777572568 |
| Mailing Telephone | 8777572568 |
| Enumeration Date | 2016-07-31 |
| Last Update Date | 2020-10-28 |
| NPI Deactivation Date | 10/05/2020 |
| NPI Reactivation Date | 2020-10-28 |
| Authorized Official Name | DR. DAVID JOHN FOREIT (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8777572568 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
02001522 | IN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE # | 256390C | 01 | |
| NPI NUMBER | 1376740647 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | FORDEM HEALTH, LLC | 1313 Park Dr., Munster, IN 46321 |
| Street Address |
1313 PARK DR |
| City | MUNSTER |
| State | IN |
| Zip Code | 46321-2634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154959179 | Munster Surgery Center LLC | Clinic/Center | 1950 45thstreet, Unit 101, Munster, IN 46321 | 2020-03-27 |
| 1467092668 | Barbara Armstrong-whitaker | Counselor | 8855 Columbia Ave, Munster, IN 46321 | 2020-01-15 |
| 1427537661 | Courtney Szydelko | Physical Therapist | 759 45th St Ste 202, Munster, IN 46321 | 2018-08-08 |
| 1407341787 | New Harvest Therapy Services, Inc. | Clinic/Center | 8124 Calumet Ave Ste B, Munster, IN 46321 | 2018-06-28 |
| 1043717945 | Region Eye Care LLC | Optometrist | 10413 Calumet Ave., Munster, IN 46321 | 2018-04-09 |
| 1003318122 | Jean M Nanos | Psychologist | 8124 Calumet Ave, Munster, IN 46321 | 2018-03-05 |
| 1841706330 | Avalon Marciniak | Speech-Language Pathologist | 1950 West 45th St., Munster, IN 46321 | 2017-12-19 |
| 1104330034 | Hinsdale Orthopaedic Associates, S.c. | Orthopaedic Surgery | 8141 S Calumet Ave, Unit 1, Munster, IN 46321 | 2017-11-30 |
| 1457871774 | Shannon Nicole Riley | Behavior Technician | 8113 Howard Ave., Munster, IN 46321 | 2017-06-27 |
| 1679017313 | Infomedica | Internal Medicine | 10010 Donald S Powers Dr, Munster, IN 46321 | 2016-12-15 |
| Find all providers in zip 46321 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285164509 | Better Quality of Life Care Md, PC | Clinic/Center | 8334 Beech Ave, Munster, IN 46321-1440 | 2017-06-19 |
| 1659439115 | Calumet Internist PC | Clinic/Center | 9122 Columbia Ave, Munster, IN 46321-2907 | 2006-12-05 |
| 1417173717 | Terry Ebert, Md, Inc | Clinic/Center | 509 Ridge Rd, Suite 1, Munster, IN 46321-1643 | 2007-04-17 |
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| 1447619747 | Sanford Dermatology | Clinic/Center | 400 W Green Meadows Dr Ste 110, Greenfield, IN 46140-3205 | 2016-02-15 |
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| 1053657775 | Earthen Vessels Nurse Midwifery LLC | Clinic/Center | 251 Airport North Office Park, Fort Wayne, IN 46825-6702 | 2012-12-27 |
| 1861757023 | Integrative Therapeutics LLC | Clinic/Center | 11074 Woods Bay Ln, Indianapolis, IN 46236-9020 | 2012-07-12 |
| 1093953234 | Wabash Valley Infectious Diseases Clinic LLC | Clinic/Center | 2112 S 3rd St, Terre Haute, IN 47802-3045 | 2009-01-27 |
| 1790966331 | Robert L Brunk II Do PC | Clinic/Center | 505 Robinhood Ct, Valparaiso, IN 46385-8021 | 2007-11-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.