| Columbus Regional Hospital | |
|
2400 East 17th St Columbus IN 47201-5351 | |
| (812) 379-4441 | |
| (812) 376-5963 |
| Full Name | Columbus Regional Hospital |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 2400 East 17th St, Columbus, Indiana |
| Authorized Official Name and Position | Marlene A Weatherwax (CFO VP OF FINANCIAL SERVICES) |
| Authorized Official Contact | 8123765205 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbus Regional Hospital 2400 East 17th St Columbus IN 47201-5351 Ph: (812) 379-4441 | Columbus Regional Hospital 2400 East 17th St Columbus IN 47201-5351 Ph: (812) 379-4441 |
| NPI Number | 1104998624 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 11/05/2013 |
| Medicare PECOS PAC ID | 7214916113 |
|---|---|
| Medicare Enrollment ID | O20050620000104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104998624 | NPI | - | NPPES |
| 100268200A | Medicaid | IN | |
| 100293890A | Medicaid | IN | |
| 000000054333 | Other | IN | BLUE CROSS |
| 100454010A | Medicaid | IN | |
| 100268190A | Medicaid | IN |
| Provider Name | Karl Wesley Evans |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558433433 PECOS PAC ID: 8820063191 Enrollment ID: I20040831000106 |
| Provider Name | Yuko Yamato |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992004584 PECOS PAC ID: 7315190170 Enrollment ID: I20130104000210 |
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