# ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.
- **Other names:** ST. VINCENT PEDIATRIC SUBSPECIALTIES
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1023203239
- **Legal business name:** ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.
- **Authorized official:** D. BRUCE HAGA (VICE PRESIDENT)
- **Authorized official phone:** (317) 583-3087

## Contact information

- **Practice address:** 2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
- **Practice address phone:** (800) 727-8439
- **Mailing address:** 10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | NULL | — |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | Yes |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | Yes |
| 2080P0203X | Pediatric Critical Care Medicine Physician | — | NULL | — |
| 2080P0203X | Pediatric Critical Care Medicine Physician | — | — | — |
| 2080P0216X | Pediatric Rheumatology Physician | — | NULL | — |
| 2080P0216X | Pediatric Rheumatology Physician | — | — | — |

## Other

- **Enumeration date:** 09/11/2007
- **Last updated:** 05/01/2008