1588143275 NPI number — GIBSON GENERAL HOSPITAL, INC

Table of content: (NPI 1588143275)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588143275 NPI number — GIBSON GENERAL HOSPITAL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GIBSON GENERAL 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:
DEACONESS GIBSON PROVIDERS
Provider Other Organization Name Type Code:
3
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:
1588143275
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1197
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EVANSVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47706-1197
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-385-9420
Provider Business Mailing Address Fax Number:
812-385-9426

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1808 SHERMAN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47670-1043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-385-9420
Provider Business Practice Location Address Fax Number:
812-385-9426
Provider Enumeration Date:
08/13/2018

Additional Information

Authorized Official

Authorized Official Last Name:
MORGAN
Authorized Official First Name:
LOIS
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT & CNO
Authorized Official Telephone Number:
812-385-9237

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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