Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
WITHAM MEMORIAL HOSPITAL
Active
Organization
WITHAM MEMORIAL HOSPITAL
Active
Other names
St. Mary Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BRAVERMAN (CEO, PRESIDENT)
(765) 485-8100
Entity
Organization
Contact information
Practice address
2201 CASON ST, LAFAYETTE, IN 47904-2613
(765) 447-4102
(765) 447-7386
Mailing address
PO BOX 221648, LOUISVILLE, KY 40252-1648
(502) 412-5847
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
08-000037-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100291350
—
IN
Enumeration date
12/12/2008
Last updated
03/26/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers