Organization
INDIANA HEALTH CENTERS, INC
Active
Other names
CHCJC ANNEX
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRACY J NAGEL (CFO)
(317) 576-1335
Entity
Organization
Contact information
Practice address
120 SAINT LOUIS AVE, SEYMOUR, IN 47274-2304
(812) 405-1857
(844) 397-1315
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
(317) 576-1335
(317) 576-1339
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100071250
—
IN
Enumeration date
07/08/2014
Last updated
03/17/2023
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