DEACONESS CLINIC INC NPI 1407804602

NPI Information

NPI: 1407804602
Provider Name: DEACONESS CLINIC, INC

Doing Business As: DEACONESS COMP CENTER GATEWAY

Classification: Clinic/Center - 261QX0100X
Entity Type: Organization

Specialization: Occupational Medicine

Address:
4011 GATEWAY BLVD STE 100
NEWBURGH, IN
ZIP 47630
Phone: (812) 858-2100
Get Directions

DEACONESS CLINIC, INC is an occupational medicine clinic center in Newburgh, IN. DEACONESS CLINIC, INC NPI is 1407804602. The provider is registered as an organization entity type.
The provider Is Doing Business As Deaconess Comp Center Gateway.

The provider's business location address is:

4011 GATEWAY BLVD STE 100
NEWBURGH, IN
ZIP 47630-947
Phone: (812) 858-2100
Fax: (812) 858-2120

The provider's authorized official is Linda E White .
The authorized official title is President & Ceo and has the following contact phone number (812) 450-2250.

The enumeration date for this NPI number is 5/4/2006 and was last updated on 1/14/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies		No
2	207Q00000X	Family Medicine		No
3	207R00000X	Internal Medicine		No
4	261QX0100X	Clinic/Center	Occupational Medicine	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200191200B	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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