Provider Demographics
NPI:1891842381
Name:SAINT CATHERINE HOSPITAL OF INDIANA LLC
Entity Type:Organization
Organization Name:SAINT CATHERINE HOSPITAL OF INDIANA LLC
Other - Org Name:SAINT CATHERINE REGIONAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:PROBUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-256-7491
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47111-0009
Mailing Address - Country:US
Mailing Address - Phone:812-256-3301
Mailing Address - Fax:812-256-7495
Practice Address - Street 1:2200 MARKET ST
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:IN
Practice Address - Zip Code:47111-9553
Practice Address - Country:US
Practice Address - Phone:812-256-7557
Practice Address - Fax:812-256-7495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2749059000OtherPASSPORT ADVANTAGE BHS
IN000000392071OtherANTHEM BC BS
KY2434052000OtherPASSPORT ADVANTAGE
KY2434052000OtherPASSPORT ADVANTAGE
IN150163Medicare ID - Type UnspecifiedMEDICARE
IN15013EMedicare ID - Type UnspecifiedMEDICARE TEMP EMERG PROV
IN15S163Medicare ID - Type UnspecifiedMEDICARE BHS UNIT