Organization
PHYSICIANS HOSPITAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMI MOORE (PROFESSIONAL SERVICE DIRECTOR)
(574) 546-1911
Entity
Organization
Contact information
Practice address
1625 E JEFFERSON BLVD, MISHAWAKA, IN 46545-7103
(574) 255-1400
Mailing address
1625 E JEFFERSON BLVD, MISHAWAKA, IN 46545-7103
(574) 255-1400
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
080056581
IN
Other
Enumeration date
09/27/2007
Last updated
01/13/2009
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