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Organization
JOHNSON MEMORIAL HOSPITAL
Active
Organization
JOHNSON MEMORIAL HOSPITAL
Active
Other names
The Waters of Wabash Skilled Nursing Facility East
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DUNKLE CPA (PRESIDENT/CEO)
(317) 736-3396
Entity
Organization
Contact information
Practice address
1900 ALBER ST, WABASH, IN 46992-1018
(260) 563-7427
(260) 563-9088
Mailing address
1125 W JEFFERSON ST, FRANKLIN, IN 46131-2140
(317) 736-3396
(317) 736-2692
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05-000006-1
IN
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100290220A
—
IN
Enumeration date
07/22/2006
Last updated
01/30/2023
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