Provider Demographics
NPI:1316019722
Name:INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INC
Entity Type:Organization
Organization Name:INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INC
Other - Org Name:IU HEALTH WHITE MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MINIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-583-1757
Mailing Address - Street 1:950 N MERIDIAN ST STE 1200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1011
Mailing Address - Country:US
Mailing Address - Phone:317-962-1093
Mailing Address - Fax:
Practice Address - Street 1:720 S 6TH ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IN
Practice Address - Zip Code:47960-8182
Practice Address - Country:US
Practice Address - Phone:574-583-7111
Practice Address - Fax:574-583-1703
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-14
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN15Z312Medicare Oscar/Certification