Provider Demographics
NPI:1710983945
Name:INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INC
Entity Type:Organization
Organization Name:INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MINIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-583-1757
Mailing Address - Street 1:950 N MERIDIAN ST STE 1200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1011
Mailing Address - Country:US
Mailing Address - Phone:317-962-1093
Mailing Address - Fax:
Practice Address - Street 1:720 S 6TH ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IN
Practice Address - Zip Code:47960-8182
Practice Address - Country:US
Practice Address - Phone:574-583-7111
Practice Address - Fax:574-583-1703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN050050341282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN351140233001OtherTRICARE
IN100270480AMedicaid
IN000000097808OtherBLUE CROSS HOSPITAL
IN100270490AMedicaid
IN351140233001OtherTRICARE
IN151312Medicare Oscar/Certification