# DEACONESS MEMORIAL MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Memorial Hospital and Health Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407815335
- **Authorized official:** MR. KEITH MILLER (CAO & INDIANA REGION PRESIDENT)
- **Authorized official phone:** (812) 996-0507

## Contact information

- **Practice address:** 800 W 9TH ST, JASPER, IN 47546-2514
- **Practice address phone:** (812) 996-2345
- **Practice address fax:** (812) 996-0214
- **Mailing address:** 800 W 9TH ST, JASPER, IN 47546-2514
- **Mailing address phone:** (812) 996-2345
- **Mailing address fax:** (812) 996-0214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 050051021 | IN | Yes |

## Other

- **Enumeration date:** 03/20/2006
- **Last updated:** 08/27/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200036390A | — | IN |