Healthcare Provider Details

I. General information

NPI: 1548241045
Provider Name (Legal Business Name): WOODLAWN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 11/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 N MAIN ST
FRANKFORT IN
46041-1167
US

IV. Provider business mailing address

1555 N MAIN ST
FRANKFORT IN
46041-1167
US

V. Phone/Fax

Practice location:
  • Phone: 765-659-1811
  • Fax: 765-659-3216
Mailing address:
  • Phone: 765-659-1811
  • Fax: 765-659-3216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number050011521
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number050011521
License Number StateIN

VIII. Authorized Official

Name: MR. JOHN ALLEY
Title or Position: PRESIDENT/CEO
Credential:
Phone: 765-659-1811