MEDICARE: ST. VINCENT HEART CENTER OF INDIANA, LLC

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
1	284300000X	Special Hospital	06-003284-2	IN

Other Identifiers

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

General Provider Information

NPI Number	:	1982681748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. VINCENT HEART CENTER OF INDIANA, LLC

Provider Business Mailing Address
First Line	:	10580 N MERIDIAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1028
Country	:	US
Telephone Number	:	317-583-5001
Fax Number	:	317-583-5405

Provider Business Practice Location Address
First Line	:	10580 N MERIDIAN ST
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46290-1028
Country	:	US
Telephone Number	:	317-583-5001
Fax Number	:	317-583-5405

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	LORI SHANNON
Credential	:
Telephone Number	:	317-583-5001

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	08/25/2020

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Directions to “ST. VINCENT HEART CENTER OF INDIANA, LLC ” Practice Location

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