1467650655 NPI number — MARGARET MARY COMMUNITY HOSPITAL, INC.

Table of content: (NPI 1467650655)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467650655 NPI number — MARGARET MARY COMMUNITY HOSPITAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARGARET MARY COMMUNITY HOSPITAL, INC.
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:
MARGARET MARY PHYSICIAN PARTNERS
Provider Other Organization Name Type Code:
5
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:
1467650655
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 236
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATESVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47006-0236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-933-5441
Provider Business Mailing Address Fax Number:
812-933-5446

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11137 US HIGHWAY 52 STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47012-7901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-647-3547
Provider Business Practice Location Address Fax Number:
765-647-2170
Provider Enumeration Date:
07/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DAEGER
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
812-933-5135

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X , with the licence number:  01035790 , 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)





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