Organization
SAINT VINCENT OF MADISON COUNTY
Active
Other names
Saint John's Medical Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANTE O PHILLIPS (DIRECTOR)
(765) 683-3201
Entity
Organization
Contact information
Practice address
1907 W SYCAMORE ST, 3RD FLOOR, KOKOMO, IN 46901-5148
(765) 236-8300
(765) 236-8302
Mailing address
2020 MERIDIAN ST, SUITE 180, ANDERSON, IN 46016-4346
(765) 683-3201
(765) 646-8625
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
69000392A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200408950A
—
IN
Enumeration date
04/23/2008
Last updated
03/16/2010
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