Provider Demographics
NPI:1437332640
Name:DYER MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:DYER MEDICAL CENTER, INC.
Other - Org Name:JEROME E. MARCH, D.O.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARCH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:219-865-1595
Mailing Address - Street 1:200 MONTICELLO DR
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-1473
Mailing Address - Country:US
Mailing Address - Phone:219-865-1595
Mailing Address - Fax:219-865-1680
Practice Address - Street 1:200 MONTICELLO DR
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-1473
Practice Address - Country:US
Practice Address - Phone:219-865-1595
Practice Address - Fax:219-865-1680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50000885A261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care