1790111680 NPI number — THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY

Table of content: (NPI 1790111680)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790111680 NPI number — THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
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:
ESKENAZI HEALTH WEST 38TH STREET PHARMACY
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:
1790111680
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
720 ESKENAZI AVENUE
Provider Second Line Business Mailing Address:
FIFTH THIRD BANK BUILDING, 5TH FLOOR
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46202-5166
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-880-3999
Provider Business Mailing Address Fax Number:
317-880-0343

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5515 W 38TH ST STE 1200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-880-0100
Provider Business Practice Location Address Fax Number:
317-880-0221
Provider Enumeration Date:
09/24/2013

Additional Information

Authorized Official

Authorized Official Last Name:
COX
Authorized Official First Name:
TODD
Authorized Official Middle Name:
Authorized Official Title or Position:
MNAGER OUTPATIENT PHARMACY
Authorized Official Telephone Number:
317-880-4340

Provider Taxonomy Codes

  • Taxonomy code: 3336C0002X , with the licence number:  60006350A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2142193 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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