Organization
ST. VINCENT PHYSICIAN NETWORK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
D BRUCE HAGA (VICE PRESIDENT)
(317) 338-7419
Entity
Organization
Contact information
Practice address
4 REBEL DRIVE, LYNN, IN 47355-8947
(765) 874-2390
Mailing address
9588 VALPARAISO COURT, INDIANAPOLIS, IN 46268
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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