Provider Demographics
NPI:1750569216
Name:MARION GENERAL HOSPITAL
Entity type:Organization
Organization Name:MARION GENERAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:USHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-662-4684
Mailing Address - Street 1:441 N WABASH AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-2612
Mailing Address - Country:US
Mailing Address - Phone:765-662-1441
Mailing Address - Fax:765-651-7351
Practice Address - Street 1:441 N WABASH AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-2612
Practice Address - Country:US
Practice Address - Phone:765-662-1441
Practice Address - Fax:765-651-7351
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARION GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-07
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200495400AMedicaid