Organization
DEACONESS HOSPITAL INC
Active
Organization
DEACONESS HOSPITAL INC
Active
Other names
Deaconess Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS FITE R.PH. (PHARMACY MANAGER)
(812) 450-3780
Entity
Organization
Contact information
Practice address
600 MARY ST, EVANSVILLE, IN 47710-1658
(812) 450-3784
(812) 450-3781
Mailing address
600 MARY ST, EVANSVILLE, IN 47710-1658
(812) 450-3784
(812) 450-3781
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336I0012X
Institutional Pharmacy
60001691A
IN
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201054000A
—
IN
01
—
2133261
PK
—
Enumeration date
01/12/2012
Last updated
12/14/2016
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