Organization
DEACONESS HOSPITAL, INC.
Active
Other names
Deaconess Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN E. CAMP (MANAGER)
(812) 450-6148
Entity
Organization
Contact information
Practice address
701 GARFIELD AVE, EVANSVILLE, IN 47710-1771
(812) 450-4673
(812) 450-4665
Mailing address
600 MARY ST, EVANSVILLE, IN 47747-0001
(812) 450-4673
(812) 450-4665
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
69000101A
IN
332BX2000X
Oxygen Equipment & Supplies (DME)
69000101A
IN
3336H0001X
Home Infusion Therapy Pharmacy
60001691A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200424320A
—
IN
05
—
35059390401
—
IL
05
—
90234451
—
KY
Enumeration date
11/09/2006
Last updated
09/12/2013
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