Provider Demographics
NPI:1144759911
Name:MUNSTER URGENT CARE INC
Entity Type:Organization
Organization Name:MUNSTER URGENT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JATIN
Authorized Official - Middle Name:RAMESH
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:219-769-6673
Mailing Address - Street 1:8840 CALUMET AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2546
Mailing Address - Country:US
Mailing Address - Phone:219-769-6673
Mailing Address - Fax:219-476-3335
Practice Address - Street 1:8840 CALUMET AVE STE 101
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2546
Practice Address - Country:US
Practice Address - Phone:219-769-6673
Practice Address - Fax:219-476-3335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200996910Medicaid