Healthcare Provider Details

I. General information

NPI: 1417614116
Provider Name (Legal Business Name): PAIN MANAGEMENT CENTERS OF AMERICA, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2021
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 W WOLFE ST
SULLIVAN IN
47882-9224
US

IV. Provider business mailing address

1101 PROFESSIONAL BLVD STE 100
EVANSVILLE IN
47714-8018
US

V. Phone/Fax

Practice location:
  • Phone: 812-268-6361
  • Fax:
Mailing address:
  • Phone: 812-477-7246
  • Fax: 812-477-7240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MAHENDRA R. SANAPATI
Title or Position: PRESIDENT
Credential: MD
Phone: 812-573-1207