# FC INDIANA, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841911591
- **Authorized official:** SYDNI CLEMMONS (CREDENTIALING MANAGER)
- **Authorized official phone:** (901) 351-1791

## Contact information

- **Practice address:** 2418 16TH ST, BEDFORD, IN 47421-3049
- **Practice address phone:** (931) 253-1110
- **Practice address fax:** (931) 722-9919
- **Mailing address:** PO BOX 306414, NASHVILLE, TN 37230-6414
- **Mailing address phone:** (931) 253-1110
- **Mailing address fax:** (931) 722-9919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/09/2022
- **Last updated:** 09/09/2022