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Organization
WITHAM MEMORIAL HOSPITAL
Active
Organization
WITHAM MEMORIAL HOSPITAL
Active
Other names
Witham Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BRAVERMAN (CEO, PRESIDENT)
(765) 485-8100
Entity
Organization
Contact information
Practice address
2605 N LEBANON ST, LEBANON, IN 46052-1476
(765) 485-8000
(765) 485-8118
Mailing address
2605 N LEBANON ST, LEBANON, IN 46052-1476
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100269130A
—
IN
05
—
100469070A
—
IN
05
—
300039905
—
IN
Enumeration date
11/17/2005
Last updated
07/02/2024
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