Provider Demographics
NPI:1841970241
Name:PROGRESSIVEHEALTH HEALTHSPOT, LLC
Entity type:Organization
Organization Name:PROGRESSIVEHEALTH HEALTHSPOT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINBOLT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, EMT-P (R)
Authorized Official - Phone:615-830-4081
Mailing Address - Street 1:150 N ROSENBERGER AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-6503
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18 RIVER WALK MALL
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-1026
Practice Address - Country:US
Practice Address - Phone:615-830-4081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROGRESSIVEHEALTH HEALTHSPOT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care