1023233137 NPI number — DEACONESS WOMEN'S HOSPITAL OF SOUTHERN IN, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023233137 NPI number — DEACONESS WOMEN'S HOSPITAL OF SOUTHERN IN, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEACONESS WOMEN'S HOSPITAL OF SOUTHERN IN, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023233137
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 637276
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45263-7276
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-842-2820
Provider Business Mailing Address Fax Number:
812-842-4226

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4199 GATEWAY BLVD,
Provider Second Line Business Practice Location Address:
SUITE 3800
Provider Business Practice Location Address City Name:
NEWBURGH
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47630-8940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-842-2820
Provider Business Practice Location Address Fax Number:
812-842-4226
Provider Enumeration Date:
04/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CADY
Authorized Official First Name:
CHRISTINA
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CONTROLLER
Authorized Official Telephone Number:
812-842-4263

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  11-002855-1 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251P0200X , with the licence number: 05008176A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com