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NPI Code Detail

MEDICARE: DEACONESS HOSPITAL, INC.

MEDICARE: DEACONESS HOSPITAL, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1114315181
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEACONESS HOSPITAL, INC.
Provider Business Mailing Address
First Line : 600 MARY ST
Second Line :
City : EVANSVILLE
State : IN
Zip : 47710-1674
Country : US
Telephone Number : 812-450-4673
Fax Number : 812-450-4665
Provider Business Practice Location Address
First Line : 3150 WARRICK DR STE 100
Second Line :
City : BOONVILLE
State : IN
Zip : 47601-8602
Country : US
Telephone Number : 812-897-5660
Fax Number : 812-897-5400
Authorized Official
Title or Position : CEO
Name : SHAWN MCCOY
Credential :
Telephone Number : 812-450-2250
Provider Enumeration Date : 12/29/2014
Last Update Date : 09/13/2018

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Directions to “DEACONESS HOSPITAL, INC. ” Practice Location

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