Provider Demographics
NPI:1063713154
Name:FUTURES FAMILY PLANNING CLINIC
Entity type:Organization
Organization Name:FUTURES FAMILY PLANNING CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER MONROE CO. HEALTH D.
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-349-2068
Mailing Address - Street 1:338 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-3500
Mailing Address - Country:US
Mailing Address - Phone:812-349-7343
Mailing Address - Fax:812-349-7346
Practice Address - Street 1:338 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-3500
Practice Address - Country:US
Practice Address - Phone:812-349-7343
Practice Address - Fax:812-349-7346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000194A261QA0005X
INMSO232354261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility