Provider Demographics
NPI:1619006988
Name:UNION HOSPITAL INC
Entity Type:Organization
Organization Name:UNION HOSPITAL INC
Other - Org Name:UNION HOSPTIAL FAMILY MEDICINE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:DOERR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-238-7000
Mailing Address - Street 1:1513 N 6 1/2 STREET
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804
Mailing Address - Country:US
Mailing Address - Phone:812-238-7631
Mailing Address - Fax:812-238-7003
Practice Address - Street 1:1513 N 6 1-2 STREET
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804
Practice Address - Country:US
Practice Address - Phone:812-238-7631
Practice Address - Fax:812-238-7003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RES000Medicare UPIN