Provider Demographics
NPI:1740304526
Name:SAINT CATHERINE HOSPITAL OF INDIANA, LLC
Entity type:Organization
Organization Name:SAINT CATHERINE HOSPITAL OF INDIANA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE / BILLING
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-256-7404
Mailing Address - Street 1:2200 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47111-9553
Mailing Address - Country:US
Mailing Address - Phone:812-256-3301
Mailing Address - Fax:812-256-6859
Practice Address - Street 1:2200 MARKET STREET
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:812-256-3301
Practice Address - Fax:812-256-6859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06-004975-1273R00000X
IN12-004975-1273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN15S163Medicare Oscar/Certification