Organization Name: | SAINT JOHN HEALTH SYSTEM |
NPI Number: | 1396773461 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | D BRUCE HAGA (VICE PRESIDENT) |
Mailing Address: | 141 W 22nd St Anderson |
State: | IN US |
Postal Code: | 460164304 |
Phone Number: | 7656417100 |
Fax Number: | 7656417115 |
NPI Enumeration Date: | 06/29/2006 |
NPI Last Update Date: | 12/03/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |