OrganizationActive
Providence Medical Associates LLC
NPI 1326654070 · Medical Specialty Clinic/Center · Indianapolis, IN
Provider details
- NPI number
- 1326654070
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Olufunke Brimmo-Longe, Owner(716) 686-2104
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1935 N Capitol Ave Ste 107
Indianapolis, IN 46202-6403
Phone: (716) 686-2104
Approximate (ZIP-level) locationGet directions
Mailing address
4000 W 106th St Ste 125-207
Carmel, IN 46032-7720
Registry dates
- Enumerated
- 2020-09-18
- Last updated
- 2020-10-22
- Certified
- 2020-10-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.