Johnson Memorial Hospital
Skilled Nursing Facility in Wakarusa, IN. Organization (NPI-2).
NPI number1962425306
StatusActive
Last updated in NPPESJan 30, 2023
Details
- NPI
- 1962425306
- Entity type
- Organization (NPI-2)
- Legal business name
- Johnson Memorial Hospital
- Organization subpart
- No
- Enumeration date
- Jul 26, 2006
- Certification date
- Jan 30, 2023
- Last updated
- Jan 30, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | 06-000521-1 | IN | Yes |
| 332BP3500X | Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | – | IN | |
| 332BN1400X | Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | – | – |
Other names
- The Waters Of Wakarusa Skilled Nursing Facility (Doing Business As)
Practice location
300 N Washington StWakarusa, IN 46573-9590
Phone 574-862-4511 · Fax 574-862-4005
Mailing address
1125 W Jefferson StFranklin, IN 46131-2140
Phone 317-736-7549 · Fax 317-736-2692
Authorized official
David Dunkle
President/Ceo
3177363396
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