Organization
CAMERON MEMORIAL COMMUNITY HOSPITAL, INC
Active
Parent organization
CAMERON MEMORIAL COMMUNITY HOSPITAL, INC
Other names
Cameron Home Health Care and Hospice
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAMERON MEMORIAL COMMUNITY HOSPITAL, INC
Authorized official
DOUGLAS BOMBA (CFO)
(260) 665-2141
Entity
Organization
Contact information
Practice address
416 E MAUMEE ST, ANGOLA, IN 46703-2015
(260) 665-2141
(260) 665-8608
Mailing address
416 E MAUMEE ST, ANGOLA, IN 46703-2015
(260) 665-2141
(260) 665-8608
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
05-005308-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097654
BLUE CROSS BLUE SHIELD PI
IN
05
—
100263930A
—
IN
01
—
1174526289
PECOS
IN
05
—
200056150A
—
IN
Enumeration date
05/23/2005
Last updated
06/06/2016
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