Provider Demographics
NPI:1467690867
Name:ST VINCENT HOSPITAL & HEALTH CARE CENTER INC
Entity Type:Organization
Organization Name:ST VINCENT HOSPITAL & HEALTH CARE CENTER INC
Other - Org Name:ASCENSION ST. VINCENT PRIMARY CARE CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER AMBULATORY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMASTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-338-2097
Mailing Address - Street 1:8414 NAAB RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1972
Mailing Address - Country:US
Mailing Address - Phone:317-338-7759
Mailing Address - Fax:317-338-7535
Practice Address - Street 1:8414 NAAB RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1972
Practice Address - Country:US
Practice Address - Phone:317-338-7759
Practice Address - Fax:317-338-7535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60005960A333600000X
3336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2118556OtherPK