Organization
INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL INC
Active
Other names
Indiana University Health La Porte VNA Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. G THOR THORDARSON (PRESIDENT/CEO)
(219) 326-2555
Entity
Organization
Contact information
Practice address
901 SOUTH WOODLAND AVE, MICHIGAN CITY, IN 46360-5672
(219) 871-8100
(219) 871-8113
Mailing address
901 SOUTH WOODLAND AVE, MICHIGAN CITY, IN 46360-5672
(219) 871-8100
(219) 871-8113
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
06-006017-1
IN
251G00000X
Community Based Hospice Care Agency
Primary
11-006017-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097786
ANTHEM
IN
05
—
200318310
—
IN
Enumeration date
10/27/2006
Last updated
09/16/2013
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