Organization
ST. MARY'S WARRICK HOSPITAL, INC.
Active
Other names
Ascension St. Vincent Warrick, St. Vincent Warrick
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY P. MATTINGLY (ADMINISTRATOR)
(812) 897-7112
Entity
Organization
Contact information
Practice address
1116 MILLIS AVENUE, BOONVILLE, IN 47601
(812) 897-4800
(812) 897-7375
Mailing address
1116 MILLIS AVE, BOONVILLE, IN 47601-2204
(812) 897-4800
(812) 897-7375
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054341
ANTHEM BLUE CROSS
IN
01
—
032184200
FEDERAL BLACK LUNG
—
05
—
100270700
—
IN
05
—
1341114
—
KY
01
—
I013944
CHAMPUS
—
Enumeration date
01/25/2007
Last updated
06/29/2020
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