Organization
MAJOR HOSPITAL
Active
Other names
The Waters of Rising Sun
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HORNER (PRESIDENT & CEO)
(317) 398-5252
Entity
Organization
Contact information
Practice address
405 RIO VISTA LN, RISING SUN, IN 47040-9497
(812) 438-2219
(812) 438-1268
Mailing address
405 RIO VISTA LN, RISING SUN, IN 47040-9497
(812) 438-2219
(812) 438-1268
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05-000405-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000383034
ANTHEM BCBS
IN
01
—
000000385261
ANTHEM PT
IN
01
—
000000385264
ANTHEM ST
IN
01
—
000000385265
ANTHEM OT
IN
05
—
100273800C
—
IN
01
—
5584960001
DMERC REGION B SUPPLIER#
IN
Enumeration date
06/04/2006
Last updated
08/07/2014
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