Provider Demographics
NPI:1043510787
Name:ST CATHERINE HOSPITAL INC
Entity Type:Organization
Organization Name:ST CATHERINE HOSPITAL INC
Other - Org Name:ST CATHERINE CARE NETWORK
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRDZELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-392-1700
Mailing Address - Street 1:4320 FIR ST
Mailing Address - Street 2:STE 320
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-3052
Mailing Address - Country:US
Mailing Address - Phone:219-554-4080
Mailing Address - Fax:
Practice Address - Street 1:4320 FIR ST
Practice Address - Street 2:STE 320
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3052
Practice Address - Country:US
Practice Address - Phone:219-554-4080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST CATHERINE HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200324900Medicaid
IN142670Medicare PIN