# ST MARY MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST MARYS MEDICAL CENTER INC
- **Other names:** Innovative Womens Health
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1306170477
- **Legal business name:** ST MARYS MEDICAL CENTER INC
- **Authorized official:** JANICE RYBA (CEO)
- **Authorized official phone:** (219) 942-0551

## Contact information

- **Practice address:** 10607 RANDOLPH ST, STE C, CROWN POINT, IN 46307-7505
- **Practice address phone:** (219) 663-1841
- **Practice address fax:** (219) 663-1846
- **Mailing address:** 9660 WICKER AVE, ST JOHN, IN 46373-9487
- **Mailing address phone:** (219) 226-2203
- **Mailing address fax:** (219) 226-2202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/23/2009
- **Last updated:** 07/11/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200966140A | — | IN |
| 05 | — | 200966140B | — | IN |