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General NPI Number Information
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NPI Number | 1528235140
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Entity Type | Organization
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Legal Business Name | ELKHART GENERAL HOSPITAL INC
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 1028 E WATERFORD ST
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City | WAKARUSA
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State | IN
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Zip | 46573-9305
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Country | US
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Telephone | 574-862-7475
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Fax | 574-862-7759
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Provider Business Mailing Address
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Address Line | 1028 E WATERFORD ST
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City | WAKARUSA
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State | IN
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Zip | 46573-9305
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Country | US
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Telephone | 574-862-7475
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Fax | 574-862-7759
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Authorized Official
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Title or Position | DIRECTOR OF MANAGED CARE
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Name | MR. C. JOHN KRAFT JR.
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Credential |
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Telephone | 574-523-7914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number | 08-005017-1
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License Number State | IN
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