1811168560 NPI number — LITTLE COMPANY OF MARY HOSPITAL OF INDIANA INC

Table of content: (NPI 1811168560)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811168560 NPI number — LITTLE COMPANY OF MARY HOSPITAL OF INDIANA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LITTLE COMPANY OF MARY HOSPITAL OF INDIANA 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:
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:
1811168560
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 W 9TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JASPER
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47546-2514
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-996-0299
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 S STATE ROAD 57 STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47501-4371
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-674-4040
Provider Business Practice Location Address Fax Number:
812-674-4041
Provider Enumeration Date:
03/20/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
KEITH
Authorized Official Middle Name:
Authorized Official Title or Position:
CAO & INDIANA REGION PRESIDENT
Authorized Official Telephone Number:
812-996-0507

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com