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General NPI Number Information
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NPI Number | 1770668030
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Entity Type | Organization
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Legal Business Name | MADISON COUNTY COMMUNITY HEALTH CENTERS INC
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 02/10/2012
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Provider Practice Location Address
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Address Line | 1547 OHIO AVENUE
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City | ANDERSON
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State | IN
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Zip | 46016
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Country | US
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Telephone | 765-641-0255
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Fax | 765-641-0256
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Provider Business Mailing Address
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Address Line | PO BOX 349 1547 OHIO AVENUE
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City | ANDERSON
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State | IN
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Zip | 46016
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Country | US
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Telephone | 765-641-0255
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Fax | 765-641-0256
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. ANTHONY J MALONE
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Credential |
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Telephone | 765-641-0255
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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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