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Organization
ST. VINCENT RANDOLPH HOSPITAL, INC.
Active
Organization
ST. VINCENT RANDOLPH HOSPITAL, INC.
Active
Other names
HOSPITALIST PROGRAM
Organization subpart
No
Provider details
NPI number
Authorized official
D. BRUCE HAGA (VICE PRESIDENT)
(317) 583-3087
Entity
Organization
Contact information
Practice address
473 E GREENVILLE AVE, WINCHESTER, IN 47394-9436
(765) 584-0339
Mailing address
10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2634117
—
OH
Enumeration date
09/11/2007
Last updated
03/04/2008
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