Healthcare Provider Details

I. General information

NPI: 1043880602
Provider Name (Legal Business Name): CAMERON MEMORIAL COMMUNITY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 02/28/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S BROAD ST
FREMONT IN
46737-2114
US

IV. Provider business mailing address

416 E MAUMEE ST
ANGOLA IN
46703-2015
US

V. Phone/Fax

Practice location:
  • Phone: 260-667-5685
  • Fax: 260-495-3621
Mailing address:
  • Phone: 260-667-5685
  • Fax: 260-495-3621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANGELA M LOGAN
Title or Position: CEO
Credential:
Phone: 260-667-5735