Provider Demographics
NPI:1609333723
Name:CENTERS FOR PAIN CONTROL, INC
Entity Type:Organization
Organization Name:CENTERS FOR PAIN CONTROL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:UJWALA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PURANIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-476-7246
Mailing Address - Street 1:2500 CALUMET AVE STE E
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-3735
Mailing Address - Country:US
Mailing Address - Phone:219-476-7246
Mailing Address - Fax:844-861-1079
Practice Address - Street 1:1928 45TH ST
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3917
Practice Address - Country:US
Practice Address - Phone:219-476-7246
Practice Address - Fax:219-476-1713
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTERS FOR PAIN CONTROL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-25
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty