Organization
ST.VINCENT MADISON COUNTY HEALTH SYSTEM
Active
Parent organization
ST.VINCENT MADISON COUNTY HEALTH SYSTEM
Other names
Saint John's Medical Supplies
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST.VINCENT MADISON COUNTY HEALTH SYSTEM
Authorized official
MR. DANTE O PHILLIPS (DME CONSULTANT)
(765) 683-3201
Entity
Organization
Contact information
Practice address
13914 STATE ROAD 238 E, ROOM 300, FISHERS, IN 46037-5506
(317) 415-9106
(765) 646-8625
Mailing address
2020 MERIDIAN ST, SUITE 180, ANDERSON, IN 46016-4346
(765) 683-3201
(765) 646-8625
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200408950A
—
IN
Enumeration date
02/18/2009
Last updated
12/20/2011
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