Healthcare Provider Details

I. General information

NPI: 1508538109
Provider Name (Legal Business Name): PAIN MANAGEMENT CENTERS OF AMERICA, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 PROFESSIONAL BLVD STE 100
EVANSVILLE IN
47714-8018
US

IV. Provider business mailing address

1101 PROFESSIONAL BLVD STE 100
EVANSVILLE IN
47714-8018
US

V. Phone/Fax

Practice location:
  • Phone: 812-573-1812
  • Fax:
Mailing address:
  • Phone: 812-477-7246
  • Fax: 812-437-0037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MAHENDRA R. SANAPATI
Title or Position: OWNER
Credential:
Phone: 812-477-7246