Provider Demographics
NPI:1740681261
Name:ST. MARY'S HEALTH, INC.
Entity type:Organization
Organization Name:ST. MARY'S HEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:JEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-485-4000
Mailing Address - Street 1:415 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47601-1809
Mailing Address - Country:US
Mailing Address - Phone:812-897-7078
Mailing Address - Fax:
Practice Address - Street 1:415 S 4TH ST
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47601-1809
Practice Address - Country:US
Practice Address - Phone:812-897-7078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport