| Southern Indiana Community Health Care, Inc | |
|
1201 N Jim Day Rd Salem IN 47167-7219 | |
| (812) 723-3944 | |
| (812) 723-7989 |
| Full Name | Southern Indiana Community Health Care, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1201 N Jim Day Rd, Salem, Indiana |
| Authorized Official Name and Position | Nancy Radcliff (CEO) |
| Authorized Official Contact | 8127233944 |
| 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) 723-3944 | Southern Indiana Community Health Care, Inc 1201 N Jim Day Rd Salem IN 47167-7219 Ph: (812) 723-3944 |
| NPI Number | 1639772353 |
|---|---|
| Provider Enumeration Date | 11/17/2020 |
| Last Update Date | 11/17/2020 |
| Medicare PECOS PAC ID | 5799694360 |
|---|---|
| Medicare Enrollment ID | O20210614000680 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639772353 | NPI | - | NPPES |
| 300017230A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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