Central Indiana Medical Group

LBN: Grand Ole Docs Of The Southside, Llc
Central Indiana Medical Group is an health care organization with primary practice located at 365 E Main St , Greenwood IN 46143-1361. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Grand Ole Docs Of The Southside, Llc can be contacted via phone (317) 881-5152, or through Richert, Charles R via phone (317) 881-5152.

Contact Information

Primary practice address
365 E Main St Greenwood IN 46143-1361
Phone: (317) 881-5152
Fax: (317) 881-8993
Website:
Map and Directions
Authorized official contact:
Name: Richert, Charles R Doctor of Medicine (MD)
Phone: (317) 881-5152

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1477653509
LBN Legal business name Grand Ole Docs Of The Southside, Llc
DBA Doing business as Central Indiana Medical Group
Authorized official Richert, Charles R Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 25th, 2006
Last updated Dec 5th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477653509 NPPES
Indiana Other 5457630006 DME
Indiana Other CI4722 DME

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