1952317661 NPI number — COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.

Table of content: (NPI 1952317661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952317661 NPI number — COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY HOSPITAL OF NOBLE COUNTY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952317661
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WAYNE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46895-5600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
260-373-7008
Provider Business Mailing Address Fax Number:
260-373-7059

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 N SAWYER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENDALLVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
260-355-3304
Provider Business Practice Location Address Fax Number:
260-347-8149
Provider Enumeration Date:
08/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RISSER
Authorized Official First Name:
STANTON
Authorized Official Middle Name:
Authorized Official Title or Position:
ACFO
Authorized Official Telephone Number:
260-266-9380

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  0212 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200320100A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 184798610 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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