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General NPI Number Information
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NPI Number | 1851780266
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Entity Type | Organization
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Legal Business Name | ST VINCENT MEDICAL GROUP INC
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 13420 N MERIDIAN ST #115
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City | CARMEL
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State | IN
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Zip | 46032-1580
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Country | US
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Telephone | 317-582-8080
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Fax |
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Provider Business Mailing Address
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Address Line | 10330 N MERIDIAN ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46290-1024
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | BRADLEY MCNABB
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Credential |
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Telephone | 317-583-3078
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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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