Provider Demographics
NPI:1518049691
Name:FREE HEALTH CLINIC OF DECATUR COUNTY
Entity Type:Organization
Organization Name:FREE HEALTH CLINIC OF DECATUR COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHRISTY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:812-663-7707
Mailing Address - Street 1:221 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47240-2048
Mailing Address - Country:US
Mailing Address - Phone:812-663-7707
Mailing Address - Fax:812-663-8297
Practice Address - Street 1:221 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-2048
Practice Address - Country:US
Practice Address - Phone:812-663-7707
Practice Address - Fax:812-663-8297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN=========Medicare UPIN