Provider Demographics
NPI:1114237682
Name:ST MARYS OHIO VALLEY HEARTCARE LLC
Entity type:Organization
Organization Name:ST MARYS OHIO VALLEY HEARTCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:FLESCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-485-6020
Mailing Address - Street 1:3700 WASHINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0541
Mailing Address - Country:US
Mailing Address - Phone:812-485-6020
Mailing Address - Fax:812-471-7523
Practice Address - Street 1:3700 WASHINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0541
Practice Address - Country:US
Practice Address - Phone:812-485-6020
Practice Address - Fax:812-471-7523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty