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Organization
WITHAM MEMORIAL HOSPITAL
Active
Organization
WITHAM MEMORIAL HOSPITAL
Active
Other names
Blair Ridge Health Campus
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BRAVERMAN (CEO, PRESIDENT)
(765) 485-8100
Entity
Organization
Contact information
Practice address
269 MEADOWVIEW DR, PERU, IN 46970-8996
(765) 472-8049
(765) 475-8895
Mailing address
PO BOX 221648, LOUISVILLE, KY 40252-1648
(502) 412-5847
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201021970
—
IN
Enumeration date
02/09/2011
Last updated
03/26/2022
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