Provider Demographics
NPI:1558346007
Name:GIBSON GENERAL HOSPITAL INC.
Entity Type:Organization
Organization Name:GIBSON GENERAL HOSPITAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND CNO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-385-9237
Mailing Address - Street 1:1808 SHERMAN DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IN
Mailing Address - Zip Code:47670-1043
Mailing Address - Country:US
Mailing Address - Phone:812-385-3401
Mailing Address - Fax:812-385-9307
Practice Address - Street 1:1808 SHERMAN DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670-1043
Practice Address - Country:US
Practice Address - Phone:812-385-3401
Practice Address - Fax:812-385-9307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No261QC0050XAmbulatory Health Care FacilitiesClinic/CenterCritical Access Hospital
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200713830OtherFIRSTSTEP
IN100269650Medicaid
IN100269630Medicaid
IN000000107485OtherANTHEM BLUE CROSS
IN15Z319Medicare Oscar/Certification
IN000000107485OtherANTHEM BLUE CROSS
IN151319Medicare Oscar/Certification
IN940920Medicare Oscar/Certification