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Organization
MEMORIAL HOSPITAL OF SOUTH BEND, INC
Active
Organization
MEMORIAL HOSPITAL OF SOUTH BEND, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY P COSTELLO (VP/CFO)
(574) 647-3549
Entity
Organization
Contact information
Practice address
403 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 647-8400
(574) 647-8410
Mailing address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
—
NULL
363A00000X
Physician Assistant
Primary
—
NULL
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/25/2014
Last updated
09/09/2014
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