Provider Demographics
NPI:1114760501
Name:DEACONESS HOSPITAL, INC.
Entity type:Organization
Organization Name:DEACONESS HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:WATHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-450-3296
Mailing Address - Street 1:701 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-1771
Mailing Address - Country:US
Mailing Address - Phone:812-450-4673
Mailing Address - Fax:812-450-4665
Practice Address - Street 1:213 S US HIGHWAY 231 STE C
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3244
Practice Address - Country:US
Practice Address - Phone:812-996-0620
Practice Address - Fax:812-996-5704
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEACONESS HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies