Black Clover Holdings Llc
General Practice
About Black Clover Holdings Llc
Black Clover Holdings Llc is a healthcare organization providing General Practice services, registered under National Provider Identifier (NPI) number 1063397867. The authorized official for Black Clover Holdings Llc is JOSHUA LEDERER.
The organization is headquartered at 7225 HERITAGE SQUARE DR STE 240, Granger, Indiana 46530. The main office can be reached at (574) 369-9102. Black Clover Holdings Llc has been NPI-registered since 2025.
Locations & Contact
Primary Location
- Address
- 7225 HERITAGE SQUARE DR STE 240
- City
- Granger
- State
- Indiana
- ZIP
- 46530-5646
- Phone
- (574) 369-9102
Authorized Official
- Name
- JOSHUA LEDERER
Mailing Address
- Address
- 54863 NORTHBRIDGE WEST CT
- City
- OSCEOLA
- State
- IN
- ZIP
- 465611309
NPI Registration
- Enumeration Date
- Last Updated
- Certification Date
Services & Taxonomy
Specialty & Classification
- Primary Specialty
- General Practice
- Classification
- General Practice
- Taxonomy Code
- 208D00000X
Medicare Enrollment
- Medicare Enrolled
- No
- Can Order/Refer
- No
- Telehealth
- No
- Excluded
- No
Frequently Asked Questions
What is Black Clover Holdings Llc's NPI number?
What does Black Clover Holdings Llc specialize in?
Where is Black Clover Holdings Llc located?
Does Black Clover Holdings Llc accept Medicare?
Does Black Clover Holdings Llc offer telehealth or virtual visits?
What is a Type 2 NPI (Organization)?
A Type 2 NPI is assigned to healthcare organizations such as hospitals, group practices, clinics, and other medical entities. Unlike Type 1 NPIs issued to individual providers, a Type 2 NPI identifies the organization itself and is used for billing, claims processing, and identification in healthcare transactions. Black Clover Holdings Llc holds NPI 1063397867, which serves as its unique identifier across all Medicare and HIPAA-covered transactions.