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NPI Code Detail

MEDICARE: ST. MARY'S HEALTH, INC.

MEDICARE: ST. MARY'S HEALTH, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366844334
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. MARY'S HEALTH, INC.
Provider Business Mailing Address
First Line : 3700 WASHINGTON AVE
Second Line :
City : EVANSVILLE
State : IN
Zip : 47750
Country : US
Telephone Number : 812-485-6940
Fax Number : 812-485-6949
Provider Business Practice Location Address
First Line : 3277 LIBERTY BLVD
Second Line : STE A
City : BOONVILLE
State : IN
Zip : 47601-9659
Country : US
Telephone Number : 812-897-8500
Fax Number : 812-897-8510
Authorized Official
Title or Position : BILLING COORDINATOR
Name : MRS. ROXANNE JARVIS
Credential :
Telephone Number : 812-485-7930
Provider Enumeration Date : 09/22/2014
Last Update Date : 03/22/2017

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Directions to “ST. MARY'S HEALTH, INC. ” Practice Location

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