Provider Demographics
NPI:1902486731
Name:PROGRESSIVEHEALTH HEALTHSPOT
Entity Type:Organization
Organization Name:PROGRESSIVEHEALTH HEALTHSPOT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR. OF EMPLOYER MEDICAL SOLUTIONS
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAINBOLT
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P(R), MBA
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:812-491-3856
Mailing Address - Fax:
Practice Address - Street 1:160 KIRBY DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:TN
Practice Address - Zip Code:37148-2003
Practice Address - Country:US
Practice Address - Phone:615-802-1414
Practice Address - Fax:615-802-1415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care