Provider Demographics
NPI:1174884472
Name:SHELBY COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:SHELBY COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-398-3746
Mailing Address - Street 1:1600 E STATE ROAD 44
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-4027
Mailing Address - Country:US
Mailing Address - Phone:317-392-6470
Mailing Address - Fax:317-392-6472
Practice Address - Street 1:1600 E STATE ROAD 44
Practice Address - Street 2:SUITE B
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-4027
Practice Address - Country:US
Practice Address - Phone:317-392-6470
Practice Address - Fax:317-392-6472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035445261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local