Provider Demographics
NPI:1023027190
Name:UNION HOSPITAL INC
Entity Type:Organization
Organization Name:UNION HOSPITAL INC
Other - Org Name:UNION HOSPITAL FAMILY MEDICINE EAST
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF PHYSICIAN OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-238-7915
Mailing Address - Street 1:4001 WABASH AVE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-1647
Mailing Address - Country:US
Mailing Address - Phone:812-238-7711
Mailing Address - Fax:812-238-7700
Practice Address - Street 1:4001 WABASH AVE
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803-1647
Practice Address - Country:US
Practice Address - Phone:812-238-7711
Practice Address - Fax:812-238-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN20074840KMedicaid
IN224370Medicare ID - Type UnspecifiedGROUP NUMBER