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General NPI Number Information
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NPI Number | 1427037175
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Entity Type | Organization
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Legal Business Name | LITTLE COMPANY OF MARY HOSPITAL OF INDIANA INC
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 800 W 9TH ST
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City | JASPER
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State | IN
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Zip | 47546-2514
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Country | US
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Telephone | 812-996-2345
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Fax | 812-996-0214
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Provider Business Mailing Address
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Address Line | 800 W 9TH ST
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City | JASPER
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State | IN
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Zip | 47546-2514
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Country | US
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Telephone | 812-996-2345
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Fax | 812-996-0214
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MR. EDWARD K BENNETT
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Credential |
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Telephone | 812-996-0507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 050059901
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License Number State | IN
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