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Organization
ST VINCENT RANDOLPH HOSPITAL
Active
Organization
ST VINCENT RANDOLPH HOSPITAL
Active
Other names
Family and Occupational Medicine of Ridgeville
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE G DESCHAMBEAU (ADMINISTRATOR)
(765) 584-0141
Entity
Organization
Contact information
Practice address
105 E 2ND ST, RIDGEVILLE, IN 47380-1325
(765) 857-2523
(765) 584-0551
Mailing address
PO BOX 428, WINCHESTER, IN 47394-0428
(765) 857-2523
(765) 584-0551
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/30/2005
Last updated
08/22/2020
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