1073550133 NPI number — TERRE HAUTE REGIONAL HOSPITAL, L.P.

Table of content: (NPI 1073550133)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073550133 NPI number — TERRE HAUTE REGIONAL HOSPITAL, L.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TERRE HAUTE REGIONAL HOSPITAL, L.P.
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:
6
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:
1073550133
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3901 S 7TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TERRE HAUTE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47802-5709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-232-0021
Provider Business Mailing Address Fax Number:
812-237-9514

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3901 S 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TERRE HAUTE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47802-5709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-232-0021
Provider Business Practice Location Address Fax Number:
812-237-9514
Provider Enumeration Date:
05/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHILSON
Authorized Official First Name:
JEFF
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
812-237-1103

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000097899 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 018141408 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1708267 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 448490 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30-4804342 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8820708 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: TER0046N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000976885Y , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 906720500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 999010846 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0570572 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100507314 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: XHSP33021 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0011432500001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01341031 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100270200A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10645A , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50000834 . This is a "PASSPORT HEALTH KY - MCO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 91021332 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000097899 . This is a "TN CARE SELECT" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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