Provider Demographics
NPI:1609060557
Name:ST. VINCENT CARMEL HOSPITAL, INC.
Entity Type:Organization
Organization Name:ST. VINCENT CARMEL HOSPITAL, INC.
Other - Org Name:ST. VINCENT WOMEN'S HEALTH BOUTIQUE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHITTENDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-582-7123
Mailing Address - Street 1:13450 N MERIDIAN ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1546
Mailing Address - Country:US
Mailing Address - Phone:317-582-0808
Mailing Address - Fax:317-582-7492
Practice Address - Street 1:13450 N MERIDIAN ST
Practice Address - Street 2:SUITE 140
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1546
Practice Address - Country:US
Practice Address - Phone:317-582-7380
Practice Address - Fax:317-582-7492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN060039321332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies