Provider Demographics
NPI:1396396842
Name:RICHLAND FAMILY PRACTICE
Entity type:Organization
Organization Name:RICHLAND FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEAGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIGHBORS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-660-0320
Mailing Address - Street 1:PO BOX 198
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47634-0198
Mailing Address - Country:US
Mailing Address - Phone:812-359-4512
Mailing Address - Fax:
Practice Address - Street 1:4088 N STATE ROAD 161
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:IN
Practice Address - Zip Code:47634-9467
Practice Address - Country:US
Practice Address - Phone:812-359-4512
Practice Address - Fax:812-359-6357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care