| Organization Name: | ST MARY MEDICAL CENTER INC |
| NPI Number: | 1902198831 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANICE L RYBA (CEO) |
| Mailing Address: | 2000 Roosevelt Rd Ste 5 Valparaiso |
| State: | IN US |
| Postal Code: | 463832800 |
| Phone Number: | 2194642123 |
| Fax Number: | 2194650032 |
| NPI Enumeration Date: | 05/11/2011 |
| NPI Last Update Date: | 05/11/2011 |
| 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: | |