Provider Demographics
NPI:1427082957
Name:ST. MARY'S HEALTH, INC.
Entity type:Organization
Organization Name:ST. MARY'S HEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-485-4000
Mailing Address - Street 1:3700 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47750-0001
Mailing Address - Country:US
Mailing Address - Phone:812-485-4000
Mailing Address - Fax:812-485-6839
Practice Address - Street 1:3700 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47750-0001
Practice Address - Country:US
Practice Address - Phone:812-485-4000
Practice Address - Fax:812-485-6839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
IN005089282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100268410AMedicaid
KY01340249Medicaid
IL=========001Medicaid
150100Medicare Oscar/Certification
KY01340249Medicaid