Healthcare Provider Details

I. General information

NPI: 1275407736
Provider Name (Legal Business Name): ST CATHERINE HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 FIR ST
EAST CHICAGO IN
46312-3049
US

IV. Provider business mailing address

4321 FIR ST
EAST CHICAGO IN
46312-3049
US

V. Phone/Fax

Practice location:
  • Phone: 219-392-7691
  • Fax:
Mailing address:
  • Phone: 219-392-7691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHAR KULLERSTRAND
Title or Position: DIRECTOR
Credential:
Phone: 219-934-8888