Provider Demographics
NPI:1568806057
Name:ST. CATHERINE HOSPITAL INC.
Entity Type:Organization
Organization Name:ST. CATHERINE HOSPITAL INC.
Other - Org Name:ST.CATHERINE HOSPITAL OUTPATIENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL DIRECTOR PATIENT FINANCIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KULLERSTRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-934-8889
Mailing Address - Street 1:4321 FIR ST
Mailing Address - Street 2:
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-3049
Mailing Address - Country:US
Mailing Address - Phone:219-392-7691
Mailing Address - Fax:
Practice Address - Street 1:4321 FIR ST.
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312
Practice Address - Country:US
Practice Address - Phone:219-392-7691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-26
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60006332A3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy