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NPI 1386042653

NPI 1386042653 : GREENE COUNTY HEALTH, INC : JASONVILLE, IN

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General NPI Number Information
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    NPI Number           |    1386042653
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    Entity Type          |    Organization 
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    Legal Business Name  |    GREENE COUNTY HEALTH, INC 
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Dates
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    Enumeration Date     |    12/18/2014
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    Last Update Date     |    07/03/2024
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Provider Practice Location Address
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    Address Line         |    326 E MAIN ST 
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    City                 |    JASONVILLE
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    State                |    IN
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    Zip                  |    47438-1510
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    Country              |    US
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    Telephone            |    812-665-9000
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    Fax                  |    812-665-9009
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Provider Business Mailing Address
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    Address Line         |    1210 N 1000 W 
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    City                 |    LINTON
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    State                |    IN
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    Zip                  |    47441-5013
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    Country              |    US
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    Telephone            |    812-699-4153
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    Fax                  |    812-699-4271
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Authorized Official
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    Title or Position    |    CFO
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    Name                 |     CRYSTAL  PLANO 
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    Credential           |    
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    Telephone            |    812-699-4153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    261QF0400X
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    Taxonomy Name        |    Federally Qualified Health Center (FQHC)
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    License Number       |    
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    License Number State |    
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