Proactive Mso, LLC
Organization Active NPI Primary Care Clinic/Center · Union Mills, IN
NPI 1285359679 · NPPES record last updated Oct 7, 2022
Key facts
- NPI
- 1285359679
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- PROACTIVE MSO, LLC
- Practice address
- 9808 S 600 W
Union Mills, IN 46382-9600 - Phone
- (574) 935-0127
- NPI assigned
- Oct 7, 2022
- Organization subpart
- No
Authorized official
- Name
- Jan Maria Hopkins
- Title
- Operations Manager
- Phone
- (864) 501-0751
Corporate family (same tax ID) 34
National Provider Directory
- Tax ID family
- W Lafayette Health Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
9808 S 600 W
Union Mills, IN 46382-9600
Mailing address
124 Allawood CT
Simpsonville, SC 29681-6207
Phone (864) 501-0751
Other names
- Proactive MD South Central Health Center
Other providers in Union Mills, IN
- Carrie Jonelle Capehart
- Jennifer Sue Jimenez
- Noble Township Volunteer Fire Department, Inc.
- Roger D Paul
- Proactive - South Central
- South Central Community School Corporation
All providers in Union Mills, IN · Primary Care Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.