Provider Demographics
NPI:1740270701
Name:SOUTHWIND HEALTHCARE INC
Entity type:Organization
Organization Name:SOUTHWIND HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:KAREN
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:HFA
Authorized Official - Phone:812-897-1375
Mailing Address - Street 1:725 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47601-1961
Mailing Address - Country:US
Mailing Address - Phone:812-897-1375
Mailing Address - Fax:812-897-5152
Practice Address - Street 1:725 S 2ND ST
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47601-1961
Practice Address - Country:US
Practice Address - Phone:812-897-1375
Practice Address - Fax:812-897-5152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
155508Medicare ID - Type Unspecified