Provider Demographics
NPI:1790896611
Name:REDI-CARE INC P C
Entity Type:Organization
Organization Name:REDI-CARE INC P C
Other - Org Name:DARYL L. HERSHBERGER, M.D.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HERSHBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-463-2468
Mailing Address - Street 1:2120 N DETROIT ST
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:IN
Mailing Address - Zip Code:46761-1147
Mailing Address - Country:US
Mailing Address - Phone:260-463-2468
Mailing Address - Fax:260-463-4237
Practice Address - Street 1:2120 N DETROIT ST
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:IN
Practice Address - Zip Code:46761-1147
Practice Address - Country:US
Practice Address - Phone:260-463-2468
Practice Address - Fax:260-463-4237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01037748A261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000299462OtherANTHEM
IN308606708OtherTRICARE
IN8757OtherPHP
IN4909200001OtherDMERC
INP00249946OtherRAILROAD MEDICARE
IN200108370AMedicaid
IN153823Medicare Oscar/Certification
IN200108370AMedicaid