Organization Name: | ST. VINCENT PHYSICIAN NETWORK LLC |
NPI Number: | 1124253901 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | D. BRUCE HAGA (VICE PRESIDENT) |
Mailing Address: | 301 Henry St Bldg B North Vernon |
State: | IN US |
Postal Code: | 472651030 |
Phone Number: | 8123524300 |
Fax Number: | |
NPI Enumeration Date: | 05/21/2009 |
NPI Last Update Date: | 08/31/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |