Provider Demographics
NPI: | 1972747913 |
---|---|
Name: | SOUTHERN INDIANA CREDIT CORPORATION |
Entity type: | Organization |
Organization Name: | SOUTHERN INDIANA CREDIT CORPORATION |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | RAY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FRITZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 812-539-2274 |
Mailing Address - Street 1: | 62 DOUGHTY RD |
Mailing Address - Street 2: | SUITE 1B |
Mailing Address - City: | LAWRENCEBURG |
Mailing Address - State: | IN |
Mailing Address - Zip Code: | 47025-2950 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 812-539-2274 |
Mailing Address - Fax: | 812-539-2275 |
Practice Address - Street 1: | 62 DOUGHTY RD |
Practice Address - Street 2: | SUITE 1B |
Practice Address - City: | LAWRENCEBURG |
Practice Address - State: | IN |
Practice Address - Zip Code: | 47025-2950 |
Practice Address - Country: | US |
Practice Address - Phone: | 812-539-2274 |
Practice Address - Fax: | 812-539-2275 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-04-21 |
Last Update Date: | 2009-04-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IN | INID69693 | 344600000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 344600000X | Transportation Services | Taxi |