Provider Demographics
NPI:1699912444
Name:ST VINCENT HOSPITAL & HEALTH CARE CENTER INC
Entity type:Organization
Organization Name:ST VINCENT HOSPITAL & HEALTH CARE CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER AMBULATORY PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMASTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-338-2097
Mailing Address - Street 1:8450 N PAYNE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6620
Mailing Address - Country:US
Mailing Address - Phone:317-338-4488
Mailing Address - Fax:317-338-4479
Practice Address - Street 1:8450 N PAYNE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-6620
Practice Address - Country:US
Practice Address - Phone:317-338-4488
Practice Address - Fax:317-338-4479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0002X
IN60005525A3336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2118555OtherPK