Providence Medical Group Llc
LBN: Providence Medical Group Llc
Providence Medical Group Llc is an health care organization with primary practice located at 2723 S 7Th St Suite A, Terre Haute IN 47802-3558. The organization recently has only one registered license in Ambulatory Health Care Facilities / Multi-Specialty, which is considered as the primary health care specialty.
Providence Medical Group Llc can be contacted via phone (812) 232-8164, or through Bittar, George B via phone (812) 232-8164.
Contact Information
Primary practice address
2723 S 7Th St Suite A
Terre Haute IN 47802-3558
Phone: (812) 232-8164
Fax: (812) 234-6391
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X | Indiana |
Profile Details
| NPI number | 1891729141 |
|---|---|
| LBN Legal business name | Providence Medical Group Llc |
| DBA Doing business as | |
| Authorized official | Bittar, George B |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Oct 9th, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891729141 | NPPES |
| Indiana | Other | CG4466 | RAILROAD MEDICARE |
| Indiana | Other | CH9272 | RAILROAD MEDICARE |
| Indiana | MEDICAID | 200261130 | RAILROAD MEDICARE |
| Indiana | MEDICAID | 200398780 | RAILROAD MEDICARE |
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