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Memorial Health System, Inc.

Organization Active NPI Physical Therapist · La Porte, IN

NPI 1013133487 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1013133487
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
MEMORIAL HEALTH SYSTEM, INC.
Practice address
900 I St
La Porte, IN 46350-5533
Phone
(219) 324-1700
NPI assigned
Apr 17, 2007
Organization subpart
No

Authorized official

Name
Mr. Jeffrey Costello
Title
VP-Cfo
Phone
(574) 647-3549

Corporate family (same tax ID) 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Goshen Family (27 organizations share this tax ID)

Locations

2301 N Bendix Dr
Ste 400
South Bend, IN 46628
Phone (219) 283-5560

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225100000X Yes

Addresses

Primary practice location

900 I St
La Porte, IN 46350-5533

Mailing address

328 N Michigan St
Suite 200
South Bend, IN 46601-1244
Phone (574) 647-1069

Other identifiers

IdentifierTypeStateIssuer
000000178974OtherINANTHEM

Other names

  • LaPorte PT Other name

Other providers in La Porte, IN

All providers in La Porte, IN · Physical Therapist in Indiana

Sources for this page

Verify at the official NPI Registry.