Healthcare Provider Details

I. General information

NPI: 1700816683
Provider Name (Legal Business Name): ECHO COMMUNITY HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 03/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 JOHN STREET SUITE 12
EVANSVILLE IN
47713-2705
US

IV. Provider business mailing address

315 MULBERRY ST
EVANSVILLE IN
47713-1252
US

V. Phone/Fax

Practice location:
  • Phone: 812-436-0224
  • Fax: 812-436-0230
Mailing address:
  • Phone: 812-421-7489
  • Fax: 812-421-7497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number261QF0400X
License Number StateIN

VIII. Authorized Official

Name: SANDEE E STRADER-MCMILLEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 812-421-7489