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Organization

JASPER COUNTY HOSPITAL

Active
Other names
Jasper County Hospital Home Medical Equipment
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFFREY D WEBB C.P.A. (VICE PRESIDENT OF FINANCIAL SERVICE)
(219) 866-5141
Entity
Organization

Contact information

Practice address
1104 E GRACE ST, RENSSELAER, IN 47978-3211
(219) 866-5141
(219) 866-3234
Mailing address
1104 E GRACE ST, RENSSELAER, IN 47978-3211
(219) 866-5141
(219) 866-3234

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
05-005072-2
IN
332B00000X
Durable Medical Equipment & Medical Supplies
05-005072-2
IN
332BN1400X
Nursing Facility Supplies (DME)
05-005072-2
IN
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
05-005072-2
IN
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
05-005072-2
IN
335E00000X
Prosthetic/Orthotic Supplier
05-005072-2
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000097206
BLUE CROSS
IN
05
100143100A
IN
05
100264290A
IN
01
11821
ARNETT
IN
01
128886900
OFFICE OF WORKMANS COMP
IN
Enumeration date
05/03/2006
Last updated
10/29/2009
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