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Contact Information

JOHNSON MEMORIAL HOSPITAL
5909 LUTE RD
PORTAGE, IN46368-4824
 Phone: 219-763-2273
 Fax: 219-764-0170
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Nursing Facility Supplies

332BN1400X 87 All Other Suppliers
 

Parenteral & Enteral Nutrition

332BP3500X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for JOHNSON MEMORIAL HOSPITAL

NPI Number 1669495008
LBN Legal business name JOHNSON MEMORIAL HOSPITAL
Authorized official STEVEN BERKHOUSE - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 07/26/2006
Last updated 01/27/2022 - About 4 years ago
Identifiers
IN License # 06-000196-1
IN Medicaid 100267390A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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