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CLARK MEMORIAL HOSPITAL NPI 1710082102


NPI Information

NPI: 1710082102
Provider Name: CLARK MEMORIAL HOSPITAL
Classification: Rehabilitation, Substance Use Disorder Unit - 276400000X
Entity Type: Organization

CLIA Number: 15D0359333

Address:
1220 MISSOURI AVE
JEFFERSONVILLE, IN
ZIP 47130
Phone: (812) 282-6631
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CLARK MEMORIAL HOSPITAL is a rehabilitation substance use disorder unit in Jeffersonville, IN. The provider is a distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) CLARK MEMORIAL HOSPITAL NPI is 1710082102. The provider is registered as an organization entity type.

The provider's business location address is:

1220 MISSOURI AVE
JEFFERSONVILLE, IN
ZIP 47130-725
Phone: (812) 282-6631
Fax: (812) 283-2688

The provider's authorized official is Kirk William Strack .
The authorized official title is Vice President Of Finance And Cfo and has the following contact phone number (812) 283-2448.

The CLIA number assigned to this NPI record is 15D0359333 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 9/13/2006 and was last updated on 8/22/2020.


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
1276400000XRehabilitation, Substance Use Disorder Unit05-005009INDIANAYes

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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