Jack Garden is a Health Service in South Bend, Indiana. Jack Garden practices all healthcare services and medical treatments related to Health Service. The NPI Number for Jack Garden is 1194860304. The last update date is 2007-07-08.
Jack Garden's current location address is 403 E Madison St, South Bend, Indiana. You can contact this provider via phone number 5742831107 and fax number 5742831131. The mailing address for Jack Garden is 403 E Madison St, South Bend, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack Garden |
|---|---|
| Address | 403 E Madison St, South Bend, Indiana |
| Phone Number | 5742831107 |
| Fax Number | 5742831131 |
| Sole Proprietor | N |
| Credentials | HSPP |
NPI Number Detail
| NPI Number | 1194860304 |
|---|---|
| Provider Enumeration Date | 2007-02-21 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 403 E Madison St |
|---|---|
| City | South Bend |
| State | Indiana (IN) |
| Post Code | 466172322 |
| Phone Number | 5742831107 |
| Fax Number | 5742831131 |
Provider's Primary Taxonomy Detail
| Speciality | Health Service |
|---|---|
| Taxonomy | 103Th0100X |
| Licence No | 20041199A |
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Post Comment/ Review Below
What is the unique identification code assigned to Jack Garden by the Centers for Medicare & Medicaid Services?
The Jack Garden has been issued the NPI (National Provider Identifier) 1194860304. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Jack Garden?
The Jack Garden is situated at 403 E Madison St, in the city of South Bend, state of IN, with the zip code 466172322.
What is Jack Garden's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jack Garden's area of specialization is Health Service, and the corresponding taxonomy code that categorizes this field of practice is 103Th0100X.
On what date did the Centers for Medicare & Medicaid Services issue the 1194860304 to Jack Garden?
The Jack Garden received its 1194860304 assignment from the Centers for Medicare & Medicaid Services on 2007-02-21.
As of what date was the information regarding Jack Garden, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jack Garden, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.