Organization
GREENE COUNTY HEALTH, INC
Active
Organization
GREENE COUNTY HEALTH, INC
Active
Other names
GREENE COUNTY HEALTH BLOOMFIELD
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL PLANO (CFO)
(812) 699-4153
Entity
Organization
Contact information
Practice address
55 N JUDGE ST, BLOOMFIELD, IN 47424-1231
(812) 384-3508
(812) 384-3083
Mailing address
1210 N 1000 W, LINTON, IN 47441-5013
(812) 384-3508
(812) 384-3083
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01030118A
IN
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063744456
NPI
IN
01
—
1194191536
NPI
IN
01
—
1326142696
NPI
IN
01
—
151006
MEDICARE FQHC
IN
01
—
1659352995
NPI
IN
05
—
201359410D
—
IN
01
—
IN2985
MEDICARE PART B (GROUP)
IN
Enumeration date
03/31/2011
Last updated
02/02/2018
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