Organization
JOHNSON MEMORIAL HOSPITAL
Active
Other names
The Waters of LaGrange 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
787 N DETROIT ST, LAGRANGE, IN 46761-1111
(574) 466-2172
(574) 463-2180
Mailing address
1125 W JEFFERSON ST, FRANKLIN, IN 46131-2140
(317) 736-3396
(317) 736-2692
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
06-000049-1
IN
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270890A
—
IN
Enumeration date
07/22/2006
Last updated
01/30/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us