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Organization
DEACONESS HOSPITAL, INC
Active
Organization
DEACONESS HOSPITAL, INC
Active
Other names
Deaconess Family Pharmacy GW
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS FITE (PHARMACY MANAGER)
(812) 450-3784
Entity
Organization
Contact information
Practice address
4209 GATEWAY BLVD., NEWBURGH, IN 47630
(812) 450-3784
Mailing address
600 MARY STREET, EVANSVILLE, IN 47747
(812) 450-3784
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336I0012X
Institutional Pharmacy
Primary
—
NULL
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568469
NCPDP
—
Enumeration date
08/28/2017
Last updated
08/28/2017
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