Echo Woodson John Street Health Care Clinic | |
501 John Street Suite 12 Evansville IN 47713-2705 | |
(812) 436-0224 | |
(812) 436-0230 |
Full Name | Echo Woodson John Street Health Care Clinic |
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Speciality | Clinic/Center |
Location | 501 John Street, Evansville, Indiana |
Authorized Official Name and Position | Sandee E Strader-mcmillen (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 8124217489 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Echo Woodson John Street Health Care Clinic 315 Mulberry St Evansville IN 47713-1252 Ph: (812) 421-7489 | Echo Woodson John Street Health Care Clinic 501 John Street Suite 12 Evansville IN 47713-2705 Ph: (812) 436-0224 |
NPI Number | 1700816683 |
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Provider Enumeration Date | 07/04/2006 |
Last Update Date | 03/18/2014 |
Medicare PECOS PAC ID | 4981515145 |
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Medicare Enrollment ID | O20090914000396 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700816683 | NPI | - | NPPES |
200079040C | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 261QF0400X (Indiana) | Primary |
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