Active NPI
Healthlinc Pharmacy LLC
- Clinic Pharmacy
- East Chicago, IN
National Provider Identifier
1891561262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic Pharmacy
- Legal business name
- HEALTHLINC PHARMACY LLC
- Practice address
- 2106 Broadway St
East Chicago, IN 46312-2218 - Phone
- (219) 318-1014
- Fax
- (219) 318-2063
- NPI assigned
- Nov 28, 2023
- Last updated
- Jun 24, 2024
- Organization subpart
- Yes
- Parent organization
- HEALTHLINC, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Melissa Mitchell
- Title
- Ceo
- Phone
- (219) 465-9503
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | |||
| Clinic Pharmacy | 3336C0002X | Primary |
Addresses
Primary practice location
2106 Broadway St
East Chicago, IN 46312-2218
Mailing address
2106 Broadway St
East Chicago, IN 46312-2218
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210122001689 | IN | Part B Supplier - Pharmacy | 0244644805 |
3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mishawaka, IN; Valparaiso, IN; Michigan City, IN; East Chicago, IN |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Healthlinc Pharmacy LLC
- Part of
- Healthlinc Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinic Pharmacy
- Valparaiso, IN
- NPI 1326603325
-
- Clinic Pharmacy
- Mishawaka, IN
- NPI 1922648476
-
- Clinic Pharmacy
- Michigan City, IN
- NPI 1689440604
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701129600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1719187200000",
"number": "1891561262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2106 BROADWAY ST",
"city": "EAST CHICAGO",
"state": "IN",
"postal_code": "463122218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2106 BROADWAY ST",
"city": "EAST CHICAGO",
"state": "IN",
"postal_code": "463122218",
"telephone_number": "219-318-1014",
"fax_number": "219-318-2063"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALTHLINC PHARMACY LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HEALTHLINC, INC",
"enumeration_date": "2023-11-28",
"last_updated": "2024-06-24",
"certification_date": "2024-06-24",
"status": "A",
"authorized_official_last_name": "MITCHELL",
"authorized_official_first_name": "MELISSA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "219-465-9503"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Clinic Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Chicago, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.