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Organization

ST MARYS AT HOME, INC

Active
Other names
St Marys Medical Equipment
Organization subpart
No

Provider details

NPI number
Authorized official
CHRIS BROSMER (MANAGER)
(812) 485-7228
Entity
Organization

Contact information

Practice address
3700 WASHINGTON AVE, EVANSVILLE, IN 47750-0001
(812) 485-4600
(812) 485-6513
Mailing address
3700 WASHINGTON AVE, EVANSVILLE, IN 47750-0001
(812) 485-4600
(812) 485-6513

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
69000397A
IN
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
69000397A
IN
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
69000397A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100247940A
IN
Enumeration date
10/28/2008
Last updated
10/28/2008
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