Provider Demographics
NPI:1598391328
Name:INDIANA HEALTHCARE PHYSICIAN SERVICES INC
Entity Type:Organization
Organization Name:INDIANA HEALTHCARE PHYSICIAN SERVICES INC
Other - Org Name:PUNXSUTAWNEY PHYSICIAN GROUP - RAPID CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:CAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-938-1451
Mailing Address - Street 1:81 HILLCREST DR STE 106
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-2605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:81 HILLCREST DR STE 106
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2605
Practice Address - Country:US
Practice Address - Phone:814-938-2064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INDIANA HEALTHCARE PHYSICIAN SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-12
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center