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General NPI Number Information
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NPI Number | 1740302827
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Entity Type | Organization
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Legal Business Name | SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 9529 W STATE ROAD 56
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City | FRENCH LICK
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State | IN
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Zip | 47432-9708
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Country | US
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Telephone | 812-936-2425
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Fax | 812-936-2599
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Provider Business Mailing Address
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Address Line | 420 W LONGEST ST PO BOX 270
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City | PAOLI
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State | IN
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Zip | 47454-8821
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Country | US
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Telephone | 812-972-3944
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Fax | 812-723-7991
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NANCY RADCLIFF
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Credential |
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Telephone | 812-723-7118
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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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