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General NPI Number Information
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NPI Number | 1720392962
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Entity Type | Organization
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Legal Business Name | ST. MARGARET MERCY HEALTHCARE CENTERS INC
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 10/01/2010
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Provider Practice Location Address
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Address Line | 701 SUPERIOR AVE
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City | MUNSTER
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State | IN
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Zip | 46321-4037
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Country | US
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Telephone | 219-836-6166
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Fax | 219-836-0768
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Provider Business Mailing Address
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Address Line | PO BOX 1000
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City | DYER
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State | IN
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Zip | 46311-0800
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Country | US
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Telephone | 219-864-2268
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Fax | 219-864-2649
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Authorized Official
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Title or Position | CONTROLLER
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Name | HEATHER MAPLE
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Credential |
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Telephone | 219-864-5296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 01026776A
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License Number State | IN
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