# SAINT JOHN'S HEALTH SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Med One South Urgent Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831270164
- **Authorized official:** MR. JAMES W MOORE (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (765) 646-8105

## Contact information

- **Practice address:** 4925 S SCATTERFIELD RD, ANDERSON, IN 46013-2911
- **Practice address phone:** (765) 646-6331
- **Practice address fax:** (765) 641-2593
- **Mailing address:** 4925 S SCATTERFIELD RD, ANDERSON, IN 46013-2911
- **Mailing address phone:** (765) 646-6331
- **Mailing address fax:** (765) 641-2593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0500X | Preventive Medicine/Occupational Environmental Medicine Physician | — | NULL | — |
| 2083P0500X | Preventive Medicine/Occupational Environmental Medicine Physician | — | — | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 12/31/2007