1891842381 NPI number — SAINT CATHERINE HOSPITAL OF INDIANA LLC

Table of Contents

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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