Healthcare Provider Details

I. General information

NPI: 1417954397
Provider Name (Legal Business Name): SCOTT CO HEALTH DEPT/CHILDREN'S HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1642C W MCCLAIN AVE
SCOTTSBURG IN
47170-1161
US

IV. Provider business mailing address

1642C W MCCLAIN AVE
SCOTTSBURG IN
47170-1161
US

V. Phone/Fax

Practice location:
  • Phone: 812-752-4185
  • Fax: 812-752-6425
Mailing address:
  • Phone: 812-752-4185
  • Fax: 812-752-6425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateIN

VIII. Authorized Official

Name: MR. JAMES RONALD MURPHY
Title or Position: ADMINISTRATOR
Credential:
Phone: 812-752-8455