PREMISE HEALTH OF INDIANA MEDICAL PC
NPI 1124796834
Clinic/Center - Multi-Specialty in Hammond, IN
- Organization
- Clinic/Center
- Multi-Specialty
- CLIA Number: 15D2010806
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-04-2026
About PREMISE HEALTH OF INDIANA MEDICAL PC
This page provides the complete NPI Profile along with additional information for Premise Health Of Indiana Medical Pc, a provider established in Hammond, Indiana operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1124796834 assigned on August 2021. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated February 2026. The authorized official of this NPI record is Edward William Schwartz (President)
- NPI
- 1124796834 Verify this NPI
- Provider Name
- PREMISE HEALTH OF INDIANA MEDICAL PC
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 777 CASINO CENTER DR HAMMOND, IN 46320
- Location Phone
- (219) 473-6100
- Location Fax
- (219) 473-6147
- Mailing Address
- 5500 MARYLAND WAY BRENTWOOD, TN 37027
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-30-2021
- Last Update Date
- 02-02-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 15D2010806
- Facility Type
- Physician Office
- Certificate Effective Date
- August 05, 2024
- Certificate Expiration Date
- August 04, 2026
- Laboratory Director
- SUSAN BARTON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Premise Health Of Indiana Medical Pc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124796834, enumerated as an "organization" on August 30, 2021.
The provider is located at 777 CASINO CENTER DR HAMMOND, IN 46320 and the phone number is (219) 473-6100.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
