| Organization Name: | SAINT JOHN HEALTH SYSTEM |
| NPI Number: | 1851614192 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANTE OTIS PHILLIPS (DME CONSULTANT) |
| Mailing Address: | 1907 W Sycamore St 3rd Floor Kokomo |
| State: | IN US |
| Postal Code: | 469015148 |
| Phone Number: | 7652368300 |
| Fax Number: | 7652368302 |
| NPI Enumeration Date: | 03/01/2010 |
| NPI Last Update Date: | 12/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 69000392A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |