Provider Demographics
NPI:1346881612
Name:PROCARE HEALTHSPOT, LLC
Entity Type:Organization
Organization Name:PROCARE HEALTHSPOT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDPAUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-491-3856
Mailing Address - Street 1:150 N ROSENBERGER AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-6503
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1016 E COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-5270
Practice Address - Country:US
Practice Address - Phone:812-435-1751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROGRESSIVEHEALTH OF INDIANA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health