Healthcare Provider Details

I. General information

NPI: 1699912444
Provider Name (Legal Business Name): ST VINCENT HOSPITAL & HEALTH CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2009
Last Update Date: 12/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8450 N PAYNE RD
INDIANAPOLIS IN
46268-6620
US

IV. Provider business mailing address

8450 N PAYNE RD
INDIANAPOLIS IN
46268-6620
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-4488
  • Fax: 317-338-4479
Mailing address:
  • Phone: 317-338-4488
  • Fax: 317-338-4479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number60005525A
License Number StateIN

VIII. Authorized Official

Name: WENDY LEMASTERS
Title or Position: MANAGER AMBULATORY PHARMACY
Credential:
Phone: 317-338-2097