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General NPI Number Information
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NPI Number | 1992094833
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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 | 03/31/2011
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Last Update Date | 02/02/2018
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Provider Practice Location Address
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Address Line | 55 N JUDGE ST
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City | BLOOMFIELD
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State | IN
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Zip | 47424-1231
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Country | US
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Telephone | 812-384-3508
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Fax | 812-384-3083
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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 | 812-384-3508
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Fax | 812-384-3083
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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 | 01030118A
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License Number State | IN
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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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