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General NPI Number Information
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NPI Number | 1730130238
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Entity Type | Organization
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Legal Business Name | ST. VINCENT RANDOLPH HOSPITAL, INC
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 473 E GREENVILLE AVE
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City | WINCHESTER
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State | IN
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Zip | 47394-9436
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Country | US
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Telephone | 765-584-0004
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Fax |
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Provider Business Mailing Address
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Address Line | 473 E GREENVILLE AVE
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City | WINCHESTER
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State | IN
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Zip | 47394-9436
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Country | US
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Telephone | 765-584-0004
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Fax |
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Authorized Official
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Title or Position | INTERIM ADMINISTRATOR
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Name | MS. KATHY YOUNG
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Credential |
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Telephone | 765-584-0107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 06-005046-1
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License Number State | IN
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