Organization
PAIN MANAGEMENT CENTERS OF AMERICA, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHENDRA R. SANAPATI MD (PRESIDENT)
(812) 477-7246
Entity
Organization
Contact information
Practice address
108 AIRWAY DR, MARION, IL 62959-5841
(618) 997-7820
(270) 554-8987
Mailing address
1101 PROFESSIONAL BLVD STE 100, EVANSVILLE, IN 47714-8018
(812) 477-7246
(812) 477-7240
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4082761171
—
IL
Enumeration date
12/18/2018
Last updated
04/30/2022
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