Basic Information
| Provider Information | |||||||||
| NPI: | 1164806444 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MONROE HOSOITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4011 S MONROE MEDICAL PARK BLVD | ||||||||
| Address2: | |||||||||
| City: | BLOOMINGTON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 474038000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8128251111 | ||||||||
| FaxNumber: | 8128250786 | ||||||||
| Practice Location | |||||||||
| Address1: | 4011 MONROE MEDICAL PARK | ||||||||
| Address2: | |||||||||
| City: | BLOOMINGTON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 47403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8128251111 | ||||||||
| FaxNumber: | 8128250786 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2015 | ||||||||
| LastUpdateDate: | 07/16/2015 | ||||||||
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| AuthorizedOfficialLastName: | PAULING | ||||||||
| AuthorizedOfficialFirstName: | KASIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | INSURANCE VERIFICATION SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 8128251111 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | IN | Y | Hospitals | General Acute Care Hospital |
No ID Information.