Healthcare Provider Details
I. General information
NPI: 1366830259
Provider Name (Legal Business Name): DEACONESS HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/31/2014
Last Update Date: 12/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2309 W FRANKLIN ST
EVANSVILLE IN
47712-5118
US
IV. Provider business mailing address
600 ARY ST
EVANSVILLE IN
47747-0001
US
V. Phone/Fax
- Phone: 812-421-9112
- Fax: 812-421-9132
- Phone: 812-450-4673
- Fax: 812-450-4665
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LINDA
E
WHITE
Title or Position: PRESIDENT/CEO
Credential: RN
Phone: 812-450-2250