| |
611 E Main St Petersburg IN 47567-1247 | |
(812) 354-8426 | |
(812) 354-9134 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 611 E Main St, Petersburg, Indiana |
Authorized Official Name and Position | Anthony Showalter (BOARD MEMEBER) |
Authorized Official Contact | 8122548620 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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611 E Main St Petersburg IN 47567-1247 Ph: (812) 354-8426 | 611 E Main St Petersburg IN 47567-1247 Ph: (812) 354-8426 |
NPI Number | 1144388505 |
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Provider Enumeration Date | 12/05/2006 |
Last Update Date | 01/02/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144388505 | NPI | - | NPPES |
200042020A | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 01028253A (Indiana) | Primary |
Good Samaritan Hospital Physician Services, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 E Main St, Suite 110, Petersburg, IN 47567 Phone: 812-354-8426 Fax: 812-354-9134 | |
Good Samaritan Family Health Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1810 E State Road 56, Petersburg, IN 47567 Phone: 810-494-9515 Fax: 812-494-9514 | |
Good Samaritan Family Health Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 E Main St Ste 110, Petersburg, IN 47567 Phone: 812-354-8785 Fax: 812-354-8786 |