Healthcare Provider Details

I. General information

NPI: 1164806444
Provider Name (Legal Business Name): MONROE HOSOITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 MONROE MEDICAL PARK
BLOOMINGTON IN
47403
US

IV. Provider business mailing address

4011 S MONROE MEDICAL PARK BLVD
BLOOMINGTON IN
47403-8000
US

V. Phone/Fax

Practice location:
  • Phone: 812-825-1111
  • Fax: 812-825-0786
Mailing address:
  • Phone: 812-825-1111
  • Fax: 812-825-0786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateIN

VIII. Authorized Official

Name: KASIE PAULING
Title or Position: INSURANCE VERIFICATION SPECIALIST
Credential:
Phone: 812-825-1111