Lawrence Brewerton
Individual provider Active NPI Nursing Facility/Intermediate Care Facility · Demotte, IN
NPI 1497972566 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497972566
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nursing Facility/Intermediate Care Facility 313M00000X
- Practice address
- 10352 N 600 E
Demotte, IN 46310-8959 - Phone
- (219) 345-5811
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | IL | Yes |
Addresses
Primary practice location
10352 N 600 E
Demotte, IN 46310-8959
Mailing address
8670 Lantern Dr
Saint John, IN 46373-9671
Phone (847) 673-0718
Other providers in Demotte, IN
- Morganne Atteberry
- Craig Balas
- Robert W Bassett
- Katherine E Behrens
- Alexis Borgman
- Jill Brogdon
- C&J Family Health Care Clinic, LLC
- Nikole Cain
- Calvary Assembly of God
- Care-Full Counseling LLC
All providers in Demotte, IN · Nursing Facility/Intermediate Care Facility in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.