Organization
ST. MARY'S WARRICK HOSPITAL, INC.
Active
Other names
Ascension St. Vincent Warrick, ER Physicians Group
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL PAROD (CEO)
(812) 485-1502
Entity
Organization
Contact information
Practice address
1116 MILLIS AVE, BOONVILLE, IN 47601-2226
(812) 897-4800
(812) 897-7375
Mailing address
1116 MILLIS AVE, BOONVILLE, IN 47601-2204
(812) 897-4800
(812) 897-7375
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
07-005111-1
IN
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
282NC0060X
Critical Access Hospital
07-005111-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054351
BLUE CROSS BLUE SHIELD
IN
01
—
032184200
FEDERAL BLACK LUNG
IN
05
—
1341114
—
KY
05
—
200043160
—
IN
01
—
I013944
CHAMPUS
IN
Enumeration date
06/13/2008
Last updated
11/10/2020
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