| St Vincent Randolph Hospital | |
|
105 E 2nd St Ridgeville IN 47380-1325 | |
| (765) 857-2523 | |
| (765) 584-0551 |
| Full Name | St Vincent Randolph Hospital |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 105 E 2nd St, Ridgeville, Indiana |
| Authorized Official Name and Position | Wayne G Deschambeau (ADMINISTRATOR) |
| Authorized Official Contact | 7655840141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Vincent Randolph Hospital Po Box 428 Winchester IN 47394-0428 Ph: (765) 857-2523 | St Vincent Randolph Hospital 105 E 2nd St Ridgeville IN 47380-1325 Ph: (765) 857-2523 |
| NPI Number | 1497748974 |
|---|---|
| Provider Enumeration Date | 08/30/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497748974 | NPI | - | NPPES |
| 2281123 | Medicaid | IN | |
| 000000105462 | Other | IN | BC/BS GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
St. Vincent Physician Network, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 E 2nd St, Ridgeville, IN 47380 Phone: 765-857-2523 | |
Reid Physician Associates, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 E 2nd St, Ridgeville, IN 47380 Phone: 765-857-2523 Fax: 765-857-2304 |