# DEACONESS MEMORIAL MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DEACONESS MEMORIAL MEDICAL CENTER INC
- **Other names:** Memorial Hospital & Health Care Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1508845397
- **Legal business name:** DEACONESS MEMORIAL MEDICAL CENTER INC
- **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) 482-2345
- **Practice address fax:** (812) 482-0214
- **Mailing address:** 800 W 9TH ST, JASPER, IN 47546-2514
- **Mailing address phone:** (812) 482-2345
- **Mailing address fax:** (812) 482-0214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 050051021 | IN | Yes |

## Other

- **Enumeration date:** 01/11/2006
- **Last updated:** 08/27/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000097731 | BLUE CROSS SKILLED NSG | IN |
| 05 | — | 100284870A | — | IN |
| 01 | — | BLACK LUNG | 301557 | IN |