Organization
ELKHART GENERAL HOSPITAL, INC.
Active
Organization
ELKHART GENERAL HOSPITAL, INC.
Active
Parent organization
ELKHART GENERAL HOSPITAL, INC.
Other names
Elkhart General Out Patient Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELKHART GENERAL HOSPITAL, INC.
Authorized official
JEFFREY P COSTELLO (CFO)
(574) 647-3460
Entity
Organization
Contact information
Practice address
600 EAST BLVD, O/P PHARMACY, ELKHART, IN 46514
(574) 523-3549
(574) 523-7802
Mailing address
600 EAST BLVD, O/P PHARMACY, ELKHART, IN 46514
(574) 523-3549
(574) 523-7802
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
60004113A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100295480A
—
IN
Enumeration date
07/18/2005
Last updated
12/01/2022
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