Healthcare Provider Details
I. General information
NPI: 1902985096
Provider Name (Legal Business Name): DEACONESS HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2006
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
209 N ELM ST
HENDERSON KY
42420-3132
US
IV. Provider business mailing address
PO BOX 1230
EVANSVILLE IN
47706-1230
US
V. Phone/Fax
- Phone: 270-686-8984
- Fax: 270-689-0054
- Phone: 812-450-6815
- Fax: 812-450-6822
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LINDA
E
WHITE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 812-450-5000