Provider Demographics
NPI:1295040160
Name:ECHO COMMUNITY HEALTH CARE INC
Entity Type:Organization
Organization Name:ECHO COMMUNITY HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:STRADER-MCMILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-421-7489
Mailing Address - Street 1:315 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1252
Mailing Address - Country:US
Mailing Address - Phone:812-421-7489
Mailing Address - Fax:812-421-7497
Practice Address - Street 1:410 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-1231
Practice Address - Country:US
Practice Address - Phone:812-421-7489
Practice Address - Fax:812-421-7497
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ECHO COMMUNITY HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-16
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200079040FMedicaid
151872Medicare Oscar/Certification