Greene County Health, Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Bloomfield, IN

NPI 1992094833 · NPPES record last updated Feb 2, 2018

Key facts

NPI
1992094833
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
GREENE COUNTY HEALTH, INC
Practice address
55 N Judge St
Bloomfield, IN 47424-1231
Phone
(812) 384-3508
Fax
(812) 384-3083
NPI assigned
Mar 31, 2011
Organization subpart
No

Authorized official

Name
Crystal Plano
Title
Cfo
Phone
(812) 699-4153

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160520000216 IN Part B Supplier - Clinic/Group Practice 7214226844 Receives reassigned benefits from 9 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jasonville, IN; Linton, IN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X 01030118A IN
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

55 N Judge St
Bloomfield, IN 47424-1231

Mailing address

1210 N 1000 W
Linton, IN 47441-5013
Phone (812) 384-3508

Other identifiers

IdentifierTypeStateIssuer
1063744456OtherINNPI
1326142696OtherINNPI
151006OtherINMEDICARE FQHC
IN2985OtherINMEDICARE PART B (GROUP)
201359410DMedicaidIN
1659352995OtherINNPI
1194191536OtherINNPI

Other names

  • GREENE COUNTY HEALTH BLOOMFIELD Doing business as

Other providers in Bloomfield, IN

All providers in Bloomfield, IN · Federally Qualified Health Center (FQHC) in Indiana

Sources for this page

Verify at the official NPI Registry.