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General NPI Number Information
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NPI Number | 1801313002
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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 | 08/28/2017
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Last Update Date | 08/28/2017
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Provider Practice Location Address
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Address Line | 4209 GATEWAY BLVD.
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City | NEWBURGH
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State | IN
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Zip | 47630
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Country | US
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Telephone | 812-450-3784
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Fax |
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Provider Business Mailing Address
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Address Line | 600 MARY STREET
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City | EVANSVILLE
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State | IN
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Zip | 47747
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Country | US
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Telephone | 812-450-3784
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | THOMAS FITE
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Credential |
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Telephone | 812-450-3784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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