MEDICARE: WOODLAWN HOSPITAL

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
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871825398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODLAWN HOSPITAL

Provider Business Mailing Address
First Line	:	1400 E 9TH ST
Second Line	:
City	:	ROCHESTER
State	:	IN
Zip	:	46975-8931
Country	:	US
Telephone Number	:	574-224-3141
Fax Number	:	574-224-1103

Provider Business Practice Location Address
First Line	:	700 MAIN ST
Second Line	:
City	:	ROCHESTER
State	:	IN
Zip	:	46975-1506
Country	:	US
Telephone Number	:	574-223-4337
Fax Number	:	574-223-5847

Authorized Official
Title or Position	:	CFO
Name	:	MR. JOHN KRAFT
Credential	:
Telephone Number	:	574-224-1118

Provider Enumeration Date	:	02/09/2010
Last Update Date	:	03/29/2019

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Directions to “WOODLAWN HOSPITAL ” Practice Location

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