Provider Demographics
NPI:1902012974
Name:FLEMING HEALTHCARE LLC
Entity Type:Organization
Organization Name:FLEMING HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NED
Authorized Official - Middle Name:E
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-922-6911
Mailing Address - Street 1:3100 45TH ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-3289
Mailing Address - Country:US
Mailing Address - Phone:219-922-6911
Mailing Address - Fax:
Practice Address - Street 1:3100 45TH ST
Practice Address - Street 2:SUITE 6
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-3289
Practice Address - Country:US
Practice Address - Phone:219-922-6911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01029679A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INE14012Medicare UPIN