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Contact Information

SULLIVAN FAMILY PRACTICE, LLC
2229 MARY SHERMAN DR
SULLIVAN, IN47882-7633
 Phone: 812-268-3318
 Fax: 812-268-4017
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Rural Health

261QR1300X B4[14] Rural Health Clinic
Indicates primary specialty

NPI Profile & details for SULLIVAN FAMILY PRACTICE, LLC

NPI # 1770502981
LBN Legal business name SULLIVAN FAMILY PRACTICE, LLC
Authorized official SUSAN HELMAN - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/19/2006
Last updated 10/26/2009 - About 17 years ago
Identifiers
IN License # 01036108
IN Medicaid 200015680A
IN Other 153868 RURAL HEALTH CLINIC
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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