Organization
SAINT JOHN HEALTH SYSTEM
Active
Parent organization
ST.VINCENT MADISON COUNTY HEALTH SYSTEM INC.
Other names
Saint John's Medical Supplies
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST.VINCENT MADISON COUNTY HEALTH SYSTEM INC.
Authorized official
MR. DANTE O PHILLIPS (DME CONSULTANT)
(765) 683-3201
Entity
Organization
Contact information
Practice address
2020 MERIDIAN ST, SUITE 180, ANDERSON, IN 46016-4346
(765) 646-8366
(765) 683-3202
Mailing address
2015 JACKSON ST, RM 248, ANDERSON, IN 46016-4337
(765) 683-3201
(765) 646-8625
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
69000167A
IN
332BX2000X
Oxygen Equipment & Supplies (DME)
69000167A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000247286
ANTHEM
—
05
—
200408950
—
IN
Enumeration date
10/06/2006
Last updated
08/09/2011
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