St. Vincent Physician Network, LLC
Clinic/Center, Rural Health in Lynn, IN. Organization (NPI-2).
NPI number1124126933
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1124126933
- Entity type
- Organization (NPI-2)
- Legal business name
- St. Vincent Physician Network, LLC
- Organization subpart
- No
- Enumeration date
- Sep 20, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | – | – | Yes |
Practice location
4 Rebel DriveLynn, IN 47355-8947
Phone 765-874-2390
Mailing address
9588 Valparaiso CourtIndianapolis, IN 46268
Authorized official
D Bruce Haga
Vice President
3173387419
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