Organization
JOHNSON MEMORIAL HOSPITAL
Active
Other names
The Waters of Syracuse Skilled Nursing Facility
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DUNKLE MD (PRESIDENT/CEO)
(317) 736-3396
Entity
Organization
Contact information
Practice address
500 E PICKWICK DR, SYRACUSE, IN 46567-2032
(574) 457-4401
(574) 457-5726
Mailing address
1125 W JEFFERSON ST, FRANKLIN, IN 46131-2140
(317) 736-7549
(317) 736-2692
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
06-000566-1
IN
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100267450A
—
IN
Enumeration date
07/26/2006
Last updated
01/30/2023
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