Provider Demographics
NPI:1598710964
Name:ST. VINCENT SETON SPECIALTY HOSPITAL, INC.
Entity Type:Organization
Organization Name:ST. VINCENT SETON SPECIALTY HOSPITAL, INC.
Other - Org Name:ASCENSION ST. VINCENT SETON SPECIALTY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-415-8500
Mailing Address - Street 1:8050 TOWNSHIP LINE ROAD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1902
Mailing Address - Country:US
Mailing Address - Phone:317-415-8500
Mailing Address - Fax:317-582-8565
Practice Address - Street 1:8050 TOWNSHIP LINE ROAD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1902
Practice Address - Country:US
Practice Address - Phone:317-415-8500
Practice Address - Fax:317-582-8565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN050033501282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200392020Medicaid
IN200392020Medicaid