Provider Demographics
NPI:1548541774
Name:RICHLAND MEDICAL CENTER, LLC
Entity type:Organization
Organization Name:RICHLAND MEDICAL CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOTTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEECE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-359-4012
Mailing Address - Street 1:2072 N COUNTY ROAD 700 W
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47634-9480
Mailing Address - Country:US
Mailing Address - Phone:812-359-4012
Mailing Address - Fax:812-359-4481
Practice Address - Street 1:2072 N COUNTY ROAD 700 W
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:IN
Practice Address - Zip Code:47634-9480
Practice Address - Country:US
Practice Address - Phone:812-359-4012
Practice Address - Fax:812-359-4481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201041160AMedicaid
IN201041160AMedicaid