MEDICARE: SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1356911390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	PO BOX 270
Second Line	:
City	:	PAOLI
State	:	IN
Zip	:	47454-0270
Country	:	US
Telephone Number	:	812-723-3944
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W WILSON ST
Second Line	:
City	:	ORLEANS
State	:	IN
Zip	:	47452-1007
Country	:	US
Telephone Number	:	812-723-3944
Fax Number	:	812-723-7989

Authorized Official
Title or Position	:	CEO
Name	:	NANCY RADCLIFF
Credential	:
Telephone Number	:	812-723-3944

Provider Enumeration Date	:	07/01/2021
Last Update Date	:	11/19/2024

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