Provider Demographics
NPI:1043640626
Name:ST. VINCENT ANDERSON REGIONAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:ST. VINCENT ANDERSON REGIONAL HOSPITAL, INC.
Other - Org Name:ST. VINCENT HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:APPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-656-8132
Mailing Address - Street 1:2015 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016-4337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13914 STATE ROAD E
Practice Address - Street 2:ROOM 300
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-5506
Practice Address - Country:US
Practice Address - Phone:317-415-9106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies