Healthcare Provider Details

I. General information

NPI: 1528160736
Provider Name (Legal Business Name): ST MARY MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1437 S LAKE PARK AVE
HOBART IN
46342
US

IV. Provider business mailing address

PO BOX 3604
MUNSTER IN
46321-0703
US

V. Phone/Fax

Practice location:
  • Phone: 219-947-6105
  • Fax: 219-947-6261
Mailing address:
  • Phone: 219-836-7370
  • Fax: 219-934-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number060053791
License Number StateIN

VIII. Authorized Official

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