Provider Demographics
NPI:1639124134
Name:ST. VINCENT CARMEL HOSPITAL, INC.
Entity Type:Organization
Organization Name:ST. VINCENT CARMEL HOSPITAL, INC.
Other - Org Name:ASCENSION ST. VINCENT CARMEL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAMMARTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-582-7123
Mailing Address - Street 1:13500 N MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1456
Mailing Address - Country:US
Mailing Address - Phone:317-582-7380
Mailing Address - Fax:317-582-7492
Practice Address - Street 1:13500 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1456
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:2006-05-23
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN060039321282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200473800AMedicaid
IN150157Medicare Oscar/Certification