Provider Demographics
NPI:1720380959
Name:SICC SERVICES LLC
Entity Type:Organization
Organization Name:SICC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILIAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ARMEANU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-491-1328
Mailing Address - Street 1:PO BOX 3276
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47731-3276
Mailing Address - Country:US
Mailing Address - Phone:812-491-1328
Mailing Address - Fax:812-492-6328
Practice Address - Street 1:350 W COLUMBIA ST # AT
Practice Address - Street 2:SUITE 440
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1782
Practice Address - Country:US
Practice Address - Phone:812-491-1328
Practice Address - Fax:812-492-6328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-19
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01063229A207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty