Organization
INDIANA UNIVERSITY HEALTH WHITE MEMORIAL HOSPITAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MINIER (PRESIDENT)
(574) 583-1757
Entity
Organization
Contact information
Practice address
720 S 6TH ST, MONTICELLO, IN 47960-8182
(574) 583-7111
(574) 583-1703
Mailing address
950 N MERIDIAN ST STE 1200, INDIANAPOLIS, IN 46204-1011
(317) 962-1093
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
050050341
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097808
BLUE CROSS HOSPITAL
IN
05
—
100270480A
—
IN
05
—
100270490A
—
IN
01
—
351140233001
TRICARE
IN
Enumeration date
06/22/2005
Last updated
10/30/2023
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