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Organization

WITHAM MEMORIAL HOSPITAL

Active
Other names
Wellbrooke of Kokomo
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY BRAVERMAN (CEO, PRESIDENT)
(765) 485-8100
Entity
Organization

Contact information

Practice address
2200 S DIXON RD, KOKOMO, IN 46902-6410
(765) 455-4443
(515) 875-4780
Mailing address
PO BOX 221648, LOUISVILLE, KY 40252-1648
(502) 412-5847

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201254360
IN
Enumeration date
11/04/2013
Last updated
05/06/2022
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