| Southern Indiana Community Health Care, Inc | |
|
420 W Longest St Paoli IN 47454-8821 | |
| (812) 723-3944 | |
| (812) 723-5292 |
| Full Name | Southern Indiana Community Health Care, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 420 W Longest St, Paoli, Indiana |
| Authorized Official Name and Position | Nancy Radcliff (CEO) |
| Authorized Official Contact | 8127237118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Indiana Community Health Care, Inc Po Box 270 Paoli IN 47454-0270 Ph: (812) 723-7118 | Southern Indiana Community Health Care, Inc 420 W Longest St Paoli IN 47454-8821 Ph: (812) 723-3944 |
| NPI Number | 1386151371 |
|---|---|
| Provider Enumeration Date | 12/29/2017 |
| Last Update Date | 02/03/2023 |
| Medicare PECOS PAC ID | 5799694360 |
|---|---|
| Medicare Enrollment ID | O20180309002045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386151371 | NPI | - | NPPES |
| 200937580A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Indiana) | Primary |
Southern Indiana Community Health Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 W Longest St, Paoli, IN 47454 Phone: 812-723-3944 Fax: 812-723-7991 | |
Southern Indiana Community Health Care, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 420 W Longest St, Paoli, IN 47454 Phone: 812-723-3944 Fax: 812-723-5292 | |
Indiana University Health Paoli Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 560 W. Longest Street, Paoli, IN 47454 Phone: 812-723-7440 |