Provider Demographics
NPI:1104871664
Name:UNION HOSPITAL INC
Entity type:Organization
Organization Name:UNION HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position: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 1:114 N DIVISION STREET
Practice Address - Street 2:
Practice Address - City:CAYUGA
Practice Address - State:IN
Practice Address - Zip Code:47928
Practice Address - Country:US
Practice Address - Phone:765-492-9042
Practice Address - Fax:765-492-9044
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNION HOSPITAL INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-23
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN153876OtherRIVERBEND
IN200074840GMedicaid
IN200074840GMedicaid
IN941090Medicare PIN
IN153876OtherRIVERBEND