Healthcare Provider Details

I. General information

NPI: 1831123942
Provider Name (Legal Business Name): MONROE HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 05/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 812-825-1111
  • Fax: 812-825-0782
Mailing address:
  • Phone: 812-825-1111
  • Fax: 812-825-0782

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: DANNY D. URBAN
Title or Position: V. P. FINANCE
Credential: CFO
Phone: 812-825-0891