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Organization
IOM HEALTH SYSTEM LP
Active
Organization
IOM HEALTH SYSTEM LP
Active
Other names
Lutheran Hospital of Indiana
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-7001
(260) 435-7632
Mailing address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-7001
(260) 435-7632
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
282N00000X
General Acute Care Hospital
Primary
05-005016-1
IN
3416A0800X
Air Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100268460A
—
IN
05
—
100379740A
—
IN
Enumeration date
05/15/2006
Last updated
07/24/2023
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