| St. Marys Warrick Hospital, Inc. | |
|
1116 Millis Avenue Boonville IN 47601 | |
| (812) 897-4800 | |
| (812) 897-7375 |
| Full Name | St. Marys Warrick Hospital, Inc. |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1116 Millis Avenue, Boonville, Indiana |
| Authorized Official Name and Position | Marty P Mattingly (ADMINISTRATOR) |
| Authorized Official Contact | 8128977112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Marys Warrick Hospital, Inc. 1116 Millis Ave Boonville IN 47601-2204 Ph: (812) 897-4800 | St. Marys Warrick Hospital, Inc. 1116 Millis Avenue Boonville IN 47601 Ph: (812) 897-4800 |
| NPI Number | 1811042237 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 06/29/2020 |
| Certification Date | 06/29/2020 |
| Medicare PECOS PAC ID | 5799722591 |
|---|---|
| Medicare Enrollment ID | O20220803002457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811042237 | NPI | - | NPPES |
| I013944 | Other | CHAMPUS | |
| 100270700 | Medicaid | IN | |
| 032184200 | Other | FEDERAL BLACK LUNG | |
| 1341114 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Secondary |
| 273R00000X | Psychiatric Unit | (Indiana) | Primary |
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