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Organization
ST MARYS AT HOME, INC
Active
Organization
ST MARYS AT HOME, INC
Active
Other names
St Marys Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS BROSMER (MANAGER)
(812) 485-7228
Entity
Organization
Contact information
Practice address
3700 WASHINGTON AVE, EVANSVILLE, IN 47750-0001
(812) 485-4600
(812) 485-6513
Mailing address
3700 WASHINGTON AVE, EVANSVILLE, IN 47750-0001
(812) 485-4600
(812) 485-6513
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
69000397A
IN
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
69000397A
IN
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
69000397A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247940A
—
IN
Enumeration date
10/28/2008
Last updated
10/28/2008
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