Organization
WHITLEY MEMORIAL HOSPITAL, INC.
Active
Parent organization
WHITLEY MEMORIAL HOSPITAL, INC.
Other names
Parkview Whitley Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
WHITLEY MEMORIAL HOSPITAL, INC.
Authorized official
MRS. JESSICA LEE-HANSEN (CFO)
(312) 388-0125
Entity
Organization
Contact information
Practice address
1260 E STATE ROAD 205, COLUMBIA CITY, IN 46725
(260) 248-9302
(260) 248-9107
Mailing address
PO BOX 5600, FORT WAYNE, IN 46895-5600
(260) 373-7008
(260) 373-7059
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
06-005090-1
IN
3336I0012X
Institutional Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000004969
MPLAN IDENTIFICATION #
IN
01
—
000000098126
INDIANA COMP. ID#
IN
05
—
01300664
—
KY
01
—
03697300
BLACK LUNG ID#
IN
05
—
100268830A
—
IN
01
—
1509946
NCPDP
—
05
—
304608369
—
MI
01
—
351965665-001
CHAMPUS IDENTIFICATION #
IN
05
—
404608378
—
MI
01
—
4744
PHP IDENTIFICATION #
IN
05
—
9422664
—
OH
Enumeration date
08/03/2006
Last updated
03/02/2026
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