Provider Demographics
NPI:1407186984
Name:BENCHIK MEDICAL HEALTH CENTER PC
Entity Type:Organization
Organization Name:BENCHIK MEDICAL HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR.
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:C
Authorized Official - Last Name:ABRINKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-659-1222
Mailing Address - Street 1:1534 119TH ST
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:IN
Mailing Address - Zip Code:46394-1733
Mailing Address - Country:US
Mailing Address - Phone:219-659-1222
Mailing Address - Fax:219-659-0428
Practice Address - Street 1:1534 119TH ST
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:IN
Practice Address - Zip Code:46394-1733
Practice Address - Country:US
Practice Address - Phone:219-659-1222
Practice Address - Fax:219-659-0428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01045436207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1255389573OtherNPI
IN200119410AMedicaid
ING43461Medicare UPIN
IN188730Medicare PIN