BACKROAD HEALTH CARE INC; NPI #1134582018

Contact Information

BACKROAD HEALTH CARE INC

211 S PERRINE AVE
CENTRALIA, IL 62801-3635

Phone: 618-419-0011
Fax: 888-980-2931
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Family	363LF0000X	50	Nurse Practitioner

Indicates primary specialty

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NPI Profile & details for BACKROAD HEALTH CARE INC

NPI Number	`1134582018`
LBN Legal business name	BACKROAD HEALTH CARE INC
Authorized official	PAUL HAVRILKA - (FNP/OWNER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	03/30/2016
Last updated	03/18/2019 - About 7 years ago
Identifiers	n/a

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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