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LITTLE COMPANY OF MARY HOSPITAL OF INDIANA INC NPI 1740360700


NPI Information

NPI: 1740360700
Provider Name: LITTLE COMPANY OF MARY HOSPITAL OF INDIANA, INC

Doing Business As: LOOGOOTEE FAMILY MEDICINE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 15D0951249

Address:
105 COOPER ST
LOOGOOTEE, IN
ZIP 47553
Phone: (812) 295-2812
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LITTLE COMPANY OF MARY HOSPITAL OF INDIANA, INC is a family medicine in Loogootee, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LITTLE COMPANY OF MARY HOSPITAL OF INDIANA, INC NPI is 1740360700. The provider is registered as an organization entity type.
The provider Is Doing Business As Loogootee Family Medicine.

The provider's business location address is:

105 COOPER ST
LOOGOOTEE, IN
ZIP 47553
Phone: (812) 295-2812
Fax: (812) 295-3726

The provider's authorized official is Edward Kyle Bennett .
The authorized official title is President, Ceo and has the following contact phone number (812) 996-0507.

The CLIA number assigned to this NPI record is 15D0951249 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/16/2006 and was last updated on 7/17/2018.


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 License Number License State Primary
1261QR1300XClinic/CenterRural HealthNo
2207Q00000XFamily MedicineYes

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
1CB3118OTHERINDIANARAILROAD MEDICARE
2200048850EMEDICAIDINDIANA

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

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