Organization
GOSHEN HOSPITAL ASSOCIATION INC
Active
Other names
Care At Home Services
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES O DAGUE (CHIEF EXECUTIVE OFFICER)
(574) 535-2700
Entity
Organization
Contact information
Practice address
1721 S MAIN ST, GOSHEN, IN 46526-4723
(574) 535-2700
Mailing address
1721 S MAIN ST, GOSHEN, IN 46526-4723
(574) 535-2700
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000098260
BCBS
IN
Enumeration date
01/31/2007
Last updated
01/23/2008
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