Provider Demographics
NPI:1316172646
Name:ST CATHERINE HOSPTIAL INC
Entity type:Organization
Organization Name:ST CATHERINE HOSPTIAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEOBARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CORREA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-392-1700
Mailing Address - Street 1:4320 FIR ST
Mailing Address - Street 2:STE 201
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-3052
Mailing Address - Country:US
Mailing Address - Phone:219-392-7664
Mailing Address - Fax:219-392-7980
Practice Address - Street 1:4320 FIR ST
Practice Address - Street 2:STE 201
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3052
Practice Address - Country:US
Practice Address - Phone:219-392-7664
Practice Address - Fax:219-392-7980
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST CATHERINE HOSPTIAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-15
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207X00000X
IN01065445A261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty