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General NPI Number Information
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NPI Number | 1902864325
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Entity Type | Organization
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Legal Business Name | JASPER COUNTY HOSPITAL
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 10/29/2009
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Provider Practice Location Address
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Address Line | 1104 E GRACE ST
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City | RENSSELAER
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State | IN
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Zip | 47978-3211
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Country | US
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Telephone | 219-866-5141
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Fax | 219-866-3234
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Provider Business Mailing Address
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Address Line | 1104 E GRACE ST
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City | RENSSELAER
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State | IN
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Zip | 47978-3211
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Country | US
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Telephone | 219-866-5141
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Fax | 219-866-3234
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Authorized Official
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Title or Position | VICE PRESIDENT OF FINANCIAL SERVICE
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Name | MR. JEFFREY D WEBB
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Credential | C.P.A.
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Telephone | 219-866-5141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 05-005072-2
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 05-005072-2
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 05-005072-2
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number | 05-005072-2
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 05-005072-2
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License Number State | IN
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Taxonomy #6
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 05-005072-2
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License Number State | IN
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