Provider Demographics
NPI:1639860778
Name:DEACONESS HOSPITAL INC
Entity Type:Organization
Organization Name:DEACONESS HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-450-3784
Mailing Address - Street 1:600 MARY ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-1658
Mailing Address - Country:US
Mailing Address - Phone:812-450-3784
Mailing Address - Fax:812-858-4530
Practice Address - Street 1:617 OAKLEY ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1647
Practice Address - Country:US
Practice Address - Phone:812-450-6338
Practice Address - Fax:812-858-4530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy