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 AVE, BOONVILLE, IN 47601-2204
(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
282NC0060X
Critical Access Hospital
05-005111-2
IN
282NC0060X
Critical Access Hospital
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054341
ANTHEM BLUE CROSS
—
01
—
032184200
FEDERAL BLACK LUNG
—
05
—
100270700
—
IN
01
—
I013944
CHAMPUS
—
Enumeration date
08/19/2005
Last updated
06/29/2020
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