Provider Demographics
NPI:1629800297
Name:RUSH MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:RUSH MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KILEY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-932-7078
Mailing Address - Street 1:1300 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1116
Mailing Address - Country:US
Mailing Address - Phone:765-932-7077
Mailing Address - Fax:765-932-7505
Practice Address - Street 1:7695 S 175 W
Practice Address - Street 2:
Practice Address - City:MILROY
Practice Address - State:IN
Practice Address - Zip Code:46156-0488
Practice Address - Country:US
Practice Address - Phone:765-932-7687
Practice Address - Fax:765-932-7505
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RUSH MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health