Provider Demographics
NPI: | 1144573601 |
---|---|
Name: | ST. VINCENT ANDERSON REGIONAL HOSPITAL, INC. |
Entity Type: | Organization |
Organization Name: | ST. VINCENT ANDERSON REGIONAL HOSPITAL, INC. |
Other - Org Name: | ASCENSION ST. VINCENT ANDERSON |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | VICE PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LAURA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ADAMS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 765-646-8132 |
Mailing Address - Street 1: | 10330 N MERIDIAN ST |
Mailing Address - Street 2: | SUITE 201 |
Mailing Address - City: | INDIANAPOLIS |
Mailing Address - State: | IN |
Mailing Address - Zip Code: | 46290-1024 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2015 JACKSON ST |
Practice Address - Street 2: | |
Practice Address - City: | ANDERSON |
Practice Address - State: | IN |
Practice Address - Zip Code: | 46016-4337 |
Practice Address - Country: | US |
Practice Address - Phone: | 765-646-8243 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-10-22 |
Last Update Date: | 2020-06-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207QH0002X | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 207LH0002X | Allopathic & Osteopathic Physicians | Anesthesiology | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 207PH0002X | Allopathic & Osteopathic Physicians | Emergency Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 207RH0002X | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 207VH0002X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 2080H0002X | Allopathic & Osteopathic Physicians | Pediatrics | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 2081H0002X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 2084H0002X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Hospice and Palliative Medicine | Group - Multi-Specialty |