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General NPI Number Information
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NPI Number | 1407292501
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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 | 05/15/2013
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Last Update Date | 10/26/2017
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Provider Practice Location Address
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Address Line | 1985 E FREEDOM DR
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City | NEWBERRY
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State | IN
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Zip | 47449-7125
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Country | US
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Telephone | 812-863-4250
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Fax | 812-863-4252
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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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