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General NPI Number Information
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NPI Number | 1114315181
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Entity Type | Organization
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Legal Business Name | DEACONESS HOSPITAL, INC.
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Dates
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Enumeration Date | 12/29/2014
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Last Update Date | 09/13/2018
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Provider Practice Location Address
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Address Line | 3150 WARRICK DR STE 100
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City | BOONVILLE
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State | IN
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Zip | 47601-8602
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Country | US
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Telephone | 812-897-5660
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Fax | 812-897-5400
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Provider Business Mailing Address
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Address Line | 600 MARY ST
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City | EVANSVILLE
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State | IN
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Zip | 47710-1674
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Country | US
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Telephone | 812-450-4673
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Fax | 812-450-4665
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Authorized Official
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Title or Position | CEO
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Name | SHAWN MCCOY
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Credential |
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Telephone | 812-450-2250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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