Healthcare Provider Details

I. General information

NPI: 1063805216
Provider Name (Legal Business Name): ECHO COMMUNITY HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2015
Last Update Date: 08/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MULBERRY ST
EVANSVILLE IN
47713-1252
US

IV. Provider business mailing address

316 CHANDLER AVE
EVANSVILLE IN
47713-1147
US

V. Phone/Fax

Practice location:
  • Phone: 812-421-7489
  • Fax: 812-436-0209
Mailing address:
  • Phone: 812-436-4501
  • Fax: 812-436-4510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: SANDEE STRADER-MCMILLEN
Title or Position: CEO
Credential:
Phone: 812-421-7489