Healthcare Provider Details

I. General information

NPI: 1902897937
Provider Name (Legal Business Name): DEKALB MEMORIAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 E 7TH ST
AUBURN IN
46706-2523
US

IV. Provider business mailing address

10501 CORPORATE DR
FORT WAYNE IN
46845-1700
US

V. Phone/Fax

Practice location:
  • Phone: 260-925-4600
  • Fax: 260-925-4733
Mailing address:
  • Phone: 260-437-7558
  • Fax: 260-925-4733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number01039551A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23002422A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number10-005041-1
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number60000349A
License Number StateIN
# 6
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MRS. JESSICA LEE-HANSEN
Title or Position: CFO
Credential:
Phone: 312-388-0125