1891842381 NPI number — SAINT CATHERINE HOSPITAL OF INDIANA LLC

Table of content: (NPI 1891842381)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891842381 NPI number — SAINT CATHERINE HOSPITAL OF INDIANA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAINT CATHERINE HOSPITAL OF INDIANA LLC
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:
1891842381
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLESTOWN
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47111-0009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-256-3301
Provider Business Mailing Address Fax Number:
812-256-7495

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLESTOWN
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47111-9553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-256-7557
Provider Business Practice Location Address Fax Number:
812-256-7495
Provider Enumeration Date:
01/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PROBUS
Authorized Official First Name:
JEFF
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
812-256-7491

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , 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)

  • Identifier: 2749059000 . This is a "PASSPORT ADVANTAGE BHS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000392071 . This is a "ANTHEM BC BS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 2434052000 . This is a "PASSPORT ADVANTAGE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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