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Organization

ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.

Active
Parent organization
ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.
Other names
ST. VINCENT PEDIATRIC SUBSPECIALTIES
Organization subpart
Yes

Provider details

NPI number
Legal business name
ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.
Authorized official
D. BRUCE HAGA (VICE PRESIDENT)
(317) 583-3087
Entity
Organization

Contact information

Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
(800) 727-8439
Mailing address
10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024

Taxonomy

Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
208000000X
Pediatrics Physician
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
2080P0203X
Pediatric Critical Care Medicine Physician
2080P0216X
Pediatric Rheumatology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200505130W
IN
Enumeration date
09/11/2007
Last updated
05/01/2008
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