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General NPI Number Information
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NPI Number | 1871869917
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Entity Type | Organization
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Legal Business Name | ST. VINCENT HOSPITAL
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Dates
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Enumeration Date | 03/22/2012
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Last Update Date | 03/22/2012
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Provider Practice Location Address
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Address Line | 13914 STATE ROAD 238 E #206
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City | FISHERS
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State | IN
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Zip | 46037-5506
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Country | US
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Telephone | 317-415-9260
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Fax | 317-415-9264
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Provider Business Mailing Address
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Address Line | 13914 STATE ROAD 238 E #206
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City | FISHERS
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State | IN
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Zip | 46037-5506
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Country | US
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Telephone | 317-415-9260
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Fax | 317-415-9264
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | CRYSTAL ROSE STREET
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Credential | AU.D.
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Telephone | 317-415-9265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | 23002486A
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License Number State | IN
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