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NPI Code Detail

MEDICARE: ELKHART GENERAL HOSPITAL FOUNDATION, INC.

MEDICARE: ELKHART GENERAL HOSPITAL FOUNDATION, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency11-005017-1IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750667184
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELKHART GENERAL HOSPITAL FOUNDATION, INC.
Provider Business Mailing Address
First Line : 600 EAST BLVD
Second Line : EGH FOUNDATION, INC./LIFELINE
City : ELKHART
State : IN
Zip : 46514-2483
Country : US
Telephone Number : 574-524-7458
Fax Number : 574-523-3383
Provider Business Practice Location Address
First Line : 2020 INDUSTRIAL PARKWAY
Second Line : LIFELINE
City : ELKHART
State : IN
Zip : 46516-5411
Country : US
Telephone Number : 574-524-7503
Fax Number : 574-524-7500
Authorized Official
Title or Position : EX. DIRECTOR OF EGH FOUNDATION, INC
Name : MR. JONATHAN W. HOUSAND JR.
Credential :
Telephone Number : 574-524-7458
Provider Enumeration Date : 10/31/2011
Last Update Date : 10/31/2011

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Directions to “ELKHART GENERAL HOSPITAL FOUNDATION, INC. ” Practice Location

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