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Organization

ST. MARY'S FREESTANDING CATH LAB LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAN ERNEST (SECRETARY/TREASURER)
(812) 485-4573
Entity
Organization

Contact information

Practice address
901 SAINT MARYS DR, EVANSVILLE, IN 47714-0520
(812) 485-7409
(812) 485-7416
Mailing address
PO BOX 15253, EVANSVILLE, IN 47716-0253
(812) 204-8429
(812) 485-7416

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36001378
KY
Enumeration date
03/23/2006
Last updated
04/20/2008
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