Provider Demographics
NPI:1033417829
Name:HEALTH SERVICES CORPORATION OF SOUTHEASTERN INDIANA
Entity Type:Organization
Organization Name:HEALTH SERVICES CORPORATION OF SOUTHEASTERN INDIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:V
Authorized Official - Last Name:RESNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-537-8200
Mailing Address - Street 1:PO BOX 4125
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-4125
Mailing Address - Country:US
Mailing Address - Phone:812-537-8245
Mailing Address - Fax:812-537-1041
Practice Address - Street 1:272 BIELBY RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1056
Practice Address - Country:US
Practice Address - Phone:812-537-8402
Practice Address - Fax:812-537-8425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
6489170001Medicare PIN