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General NPI Number Information
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NPI Number | 1801204201
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Entity Type | Organization
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Legal Business Name | WITHAM MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 07/29/2014
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 2705 N LEBANON ST
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City | LEBANON
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State | IN
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Zip | 46052-8621
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Country | US
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Telephone | 765-485-8390
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Fax | 765-485-8399
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Provider Business Mailing Address
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Address Line | 2705 N LEBANON ST
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City | LEBANON
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State | IN
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Zip | 46052-8621
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Country | US
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Telephone | 765-485-8390
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Fax | 765-485-8399
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | AARON LEE
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Credential |
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Telephone | 765-485-8395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 60000062A
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License Number State | IN
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