Organization
DEKALB MEMORIAL HOSPITAL INC
Active
Other names
Dekalb Health
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG POLKOW (CEO)
(260) 920-2501
Entity
Organization
Contact information
Practice address
400 ERIE PASS, AUBURN, IN 46706-2523
(260) 925-1255
Mailing address
PO BOX 623, AUBURN, IN 46706-0623
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
191560
MEDICARE PTAN
IN
Enumeration date
01/27/2017
Last updated
01/27/2017
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