# ST. VINCENT CHILDREN'S SPECIALTY HOSPITAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St. Vincent Children's Specialty Hospital Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730239849
- **Authorized official:** ROLAND FUNSTEN (ASST VP FINANCE)
- **Authorized official phone:** (317) 338-8198

## Contact information

- **Practice address:** 1707 W 86TH ST, INDIANAPOLIS, IN 46260-2002
- **Practice address phone:** (317) 415-5500
- **Mailing address:** PO BOX 68952, INDIANAPOLIS, IN 46268-0952
- **Mailing address phone:** (317) 870-6740
- **Mailing address fax:** (317) 870-0499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/11/2007
- **Last updated:** 08/22/2020