Healthcare Provider Details
I. General information
NPI: 1346248986
Provider Name (Legal Business Name): JOHNSON MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2005
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1125 W JEFFERSON ST
FRANKLIN IN
46131-2140
US
IV. Provider business mailing address
1125 W JEFFERSON ST
FRANKLIN IN
46131-2140
US
V. Phone/Fax
- Phone: 317-736-3300
- Fax: 317-738-7872
- Phone: 317-736-3858
- Fax: 317-738-7872
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336I0012X |
| Taxonomy | Institutional Pharmacy |
| License Number | 60000316B |
| License Number State | IN |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | 14-005001-1 |
| License Number State | IN |
VIII. Authorized Official
Name:
ADAM
B
PUTVIN
Title or Position: CFO
Credential:
Phone: 317-736-3300