Basic Information
Provider Information
NPI: 1437679958
EntityType: 2
ReplacementNPI:  
OrganizationName: UNITY HEALTHCARE, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: FLORA FAMILY MEDICINE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 4699
Address2:  
City: LAFAYETTE
State: IN
PostalCode: 479034699
CountryCode: US
TelephoneNumber: 7654492732
FaxNumber: 7654491196
Practice Location
Address1: 2002 WEST COUNTY ROAD 0 N/S
Address2:  
City: FRANKFORT
State: IN
PostalCode: 46041
CountryCode: US
TelephoneNumber: 7656706910
FaxNumber: 7656706438
Other Information
ProviderEnumerationDate: 06/26/2017
LastUpdateDate: 06/26/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MILLER
AuthorizedOfficialFirstName: MARTHA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DIRECTOR OF BILLING
AuthorizedOfficialTelephone: 7654465417
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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