Provider Demographics
NPI:1750458667
Name:UNION HOSPITAL INC
Entity Type:Organization
Organization Name:UNION HOSPITAL INC
Other - Org Name:UNION HOSPITAL NEUROSCIENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SYSTEMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLUTCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-238-7000
Mailing Address - Street 1:PO BOX 2505
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-2505
Mailing Address - Country:US
Mailing Address - Phone:812-238-7783
Mailing Address - Fax:812-238-4506
Practice Address - Street 1:1530 N 7TH ST
Practice Address - Street 2:SUITE 501
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807-1057
Practice Address - Country:US
Practice Address - Phone:812-238-4555
Practice Address - Fax:812-238-4517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2011-01-25
Deactivation Date:2007-11-05
Deactivation Code:
Reactivation Date:2008-05-29
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0510320012Medicare NSC