Healthcare Provider Details

I. General information

NPI: 1518040088
Provider Name (Legal Business Name): MARION GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 09/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 N WABASH AVE
MARION IN
46952-2612
US

IV. Provider business mailing address

441 N WABASH AVE
MARION IN
46952-2612
US

V. Phone/Fax

Practice location:
  • Phone: 765-662-1441
  • Fax:
Mailing address:
  • Phone: 765-662-1441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number06-005011-1
License Number StateIN

VIII. Authorized Official

Name: MR. PAUL USHER
Title or Position: CEO
Credential:
Phone: 765-662-4684