Provider Demographics
NPI:1285845057
Name:INDIANA UNIVERSITY HEALTH PAOLI INC
Entity Type:Organization
Organization Name:INDIANA UNIVERSITY HEALTH PAOLI INC
Other - Org Name:IU HEALTH PAOLI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-353-9171
Mailing Address - Street 1:642 W HOSPITAL RD
Mailing Address - Street 2:P O BOX 499
Mailing Address - City:PAOLI
Mailing Address - State:IN
Mailing Address - Zip Code:47454-9672
Mailing Address - Country:US
Mailing Address - Phone:812-723-2811
Mailing Address - Fax:812-723-7506
Practice Address - Street 1:642 W HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:IN
Practice Address - Zip Code:47454-9672
Practice Address - Country:US
Practice Address - Phone:812-723-2811
Practice Address - Fax:812-723-7506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN15Z306Medicare Oscar/Certification