Organization
HENRY COUNTY URGENT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL F JANSSEN (PRESIDENT)
(765) 521-1508
Entity
Organization
Contact information
Practice address
113 SOUTH MEMORIAL DRIVE, NEW CASTLE, IN 47362-4947
(765) 521-1366
(765) 521-1555
Mailing address
PO BOX 337, NEW CASTLE, IN 47362-0337
(765) 521-1366
(765) 521-1555
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224292
ANTHEM
IN
05
—
200406810A
—
IN
Enumeration date
11/01/2006
Last updated
12/07/2009
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