Provider Demographics
NPI:1316440530
Name:LITTLE COMPANY OF MARY HOSPITAL OF INDIANA INC
Entity type:Organization
Organization Name:LITTLE COMPANY OF MARY HOSPITAL OF INDIANA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-996-0507
Mailing Address - Street 1:800 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-2514
Mailing Address - Country:US
Mailing Address - Phone:812-996-8584
Mailing Address - Fax:812-996-8497
Practice Address - Street 1:251 S TRUMAN RD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-9768
Practice Address - Country:US
Practice Address - Phone:812-996-5575
Practice Address - Fax:812-996-5580
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LITTLE COMPANY OF MARY HOSPITAL OF INDIANA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-14
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty