Sullivan County Internal Medicine Llc is a medicare enrolled primary clinic (Internal Medicine) in Shelburn, Indiana. The current practice location for Sullivan County Internal Medicine Llc is 557 W Broadway St, Shelburn, Indiana. For appointments, you can reach them via phone at
(812) 397-2440. The mailing address for Sullivan County Internal Medicine Llc is 3991 Golf Bag Ln, Terre Haute, Indiana and phone number is (812) 249-9904.
Sullivan County Internal Medicine Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1871058529. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(812) 397-2440.
Primary Care Clinic Profile
| Full Name | Sullivan County Internal Medicine Llc |
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| Speciality | Internal Medicine |
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| Location | 557 W Broadway St, Shelburn, Indiana |
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| Authorized Official Name and Position | Divyesh Purohit (M.D.) |
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| Authorized Official Contact | 8122499904 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Sullivan County Internal Medicine Llc
3991 Golf Bag Ln
Terre Haute
IN 47802-8145
Ph: (812) 249-9904 | Sullivan County Internal Medicine Llc
557 W Broadway St
Shelburn
IN 47879-1232
Ph: (812) 397-2440 |
NPI Details:
| NPI Number | 1871058529 |
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| Provider Enumeration Date | 02/07/2019 |
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| Last Update Date | 09/14/2023 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 6305185398 |
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| Medicare Enrollment ID | O20190311000196 |
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Medical Identifiers
Medical identifiers for Sullivan County Internal Medicine Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1871058529 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Sullivan County Internal Medicine Llc acts as a billing entity for following providers:
| Provider Name | Divyesh Purohit |
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| Provider Type | Practitioner - Emergency Medicine |
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| Provider Identifiers | NPI Number: 1326028309
PECOS PAC ID: 2668367137
Enrollment ID: I20040216000600 |
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