Provider Demographics
NPI:1013087048
Name:UNION HOSPITAL INC
Entity Type:Organization
Organization Name:UNION HOSPITAL INC
Other - Org Name:BRAZIL FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-238-7606
Mailing Address - Street 1:221 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-4214
Mailing Address - Country:US
Mailing Address - Phone:812-242-3157
Mailing Address - Fax:812-242-3861
Practice Address - Street 1:115 S MURPHY AVE
Practice Address - Street 2:STE A
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-8296
Practice Address - Country:US
Practice Address - Phone:812-442-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200853600AMedicaid
TN153869Medicare PIN