Basic Information
| Provider Information | |||||||||
| NPI: | 1861411464 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MIDWEST HEALTHSTRATEGIES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3813 S MADISON AVE | ||||||||
| Address2: | |||||||||
| City: | MUNCIE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 47302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7657513303 | ||||||||
| FaxNumber: | 7657513353 | ||||||||
| Practice Location | |||||||||
| Address1: | 205 N TILLOTSON AVENUE | ||||||||
| Address2: | |||||||||
| City: | MUNCIE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 473043900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7652549717 | ||||||||
| FaxNumber: | 7652549739 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 09/24/2008 | ||||||||
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| AuthorizedOfficialLastName: | GILDERSLEEVE | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | E. | ||||||||
| AuthorizedOfficialTitleorPosition: | CHAIRMAN OF THE BOARD | ||||||||
| AuthorizedOfficialTelephone: | 7657473365 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | N | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 261QR0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 200390490B | 05 | IN | MEDICAID | 000000353791 | 01 | IN | ANTHEM BCBS | OTHER |