Provider Demographics
NPI:1831123942
Name:MONROE HOSPITAL, LLC
Entity Type:Organization
Organization Name:MONROE HOSPITAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V. P. FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:D
Authorized Official - Last Name:URBAN
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:812-825-0891
Mailing Address - Street 1:4011 S MONROE MEDICAL PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-4011
Mailing Address - Country:US
Mailing Address - Phone:812-825-1111
Mailing Address - Fax:812-825-0782
Practice Address - Street 1:4011 S MONROE MEDICAL PARK BLVD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-4011
Practice Address - Country:US
Practice Address - Phone:812-825-1111
Practice Address - Fax:812-825-0782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200836430AMedicaid
IN200836430AMedicaid
IN252770Medicare PIN