MEDICARE: WOODLAWN HOSPITAL

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
1	314000000X	Skilled Nursing Facility	200382090A	IN

Other Identifiers

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

General Provider Information

NPI Number	:	1982686242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODLAWN HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 1
Second Line	:
City	:	DONALDSON
State	:	IN
Zip	:	46513-0001
Country	:	US
Telephone Number	:	574-935-1724
Fax Number	:	574-935-1710

Provider Business Practice Location Address
First Line	:	9601 UNION RD
Second Line	:
City	:	PLYMOUTH
State	:	IN
Zip	:	46563
Country	:	US
Telephone Number	:	574-935-1724
Fax Number	:	574-935-1710

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	JOHN KRAFT
Credential	:
Telephone Number	:	574-224-1118

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	08/06/2018

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Directions to “WOODLAWN HOSPITAL ” Practice Location

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