St. Mary's Freestanding Cath Lab LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ST. MARY'S FREESTANDING CATH LAB LLC

Practice address

901 Saint Marys Dr
Evansville, IN 47714-0520

Phone

(812) 485-7409

Fax

(812) 485-7416

NPI assigned

Mar 23, 2006

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jan Ernest

Title

Secretary/Treasurer

Phone

(812) 485-4573

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1760442883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15253",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477160253",
            "telephone_number": "812-204-8429",
            "fax_number": "812-485-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SAINT MARYS DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140520",
            "telephone_number": "812-485-7409",
            "fax_number": "812-485-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S FREESTANDING CATH LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "ERNEST",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "812-485-4573",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36001378",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Evansville, IN
• Providers in Evansville, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.