| Division Street Family Clinic | |
|
25 W Division St Evansville IN 47710-1374 | |
| (812) 436-0205 | |
| (812) 436-0207 |
| Full Name | Division Street Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 25 W Division St, Evansville, Indiana |
| Authorized Official Name and Position | Sandee Strader-mcmillen (CEO) |
| Authorized Official Contact | 8124217489 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Division Street Family Clinic 315 Mulberry St Evansville IN 47713-1252 Ph: (812) 421-7489 | Division Street Family Clinic 25 W Division St Evansville IN 47710-1374 Ph: (812) 436-0205 |
| NPI Number | 1467483255 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 07/15/2015 |
| Medicare PECOS PAC ID | 4981515145 |
|---|---|
| Medicare Enrollment ID | O20030911000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467483255 | NPI | - | NPPES |
| 200079040 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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