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NPI Code Detail

MEDICARE: CAMERON MEMORIAL COMMUNITY HOSPITAL, INC

MEDICARE: CAMERON MEMORIAL COMMUNITY HOSPITAL, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency05-005308-1IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11174526289OTHERINPECOS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000000097654OTHERINBLUE CROSS BLUE SHIELD PI
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174526289
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAMERON MEMORIAL COMMUNITY HOSPITAL, INC
Provider Business Mailing Address
First Line : 416 E MAUMEE ST
Second Line :
City : ANGOLA
State : IN
Zip : 46703-2015
Country : US
Telephone Number : 260-665-2141
Fax Number : 260-665-8608
Provider Business Practice Location Address
First Line : 416 E MAUMEE ST
Second Line :
City : ANGOLA
State : IN
Zip : 46703-2015
Country : US
Telephone Number : 260-665-2141
Fax Number : 260-665-8608
Authorized Official
Title or Position : CFO
Name : DOUGLAS BOMBA
Credential :
Telephone Number : 260-665-2141
Provider Enumeration Date : 05/23/2005
Last Update Date : 06/06/2016

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Directions to “CAMERON MEMORIAL COMMUNITY HOSPITAL, INC ” Practice Location

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