Organization
JASPER COUNTY HOSPITAL
Active
Parent organization
JASPER COUNTY HOSPITAL
Other names
Jasper County Hospital DeMotte Medical Equipment
Organization subpart
Yes
Provider details
NPI number
Legal business name
JASPER COUNTY HOSPITAL
Authorized official
JEFFREY D WEBB C.P.A. (VICE PRESIDENT OF FINANCIAL SERVICE)
(219) 866-5141
Entity
Organization
Contact information
Practice address
520 S HALLECK STREET, DEMOTTE, IN 46310-8630
(219) 987-6762
(219) 987-6763
Mailing address
1104 E GRACE ST, RENSSELAER, IN 47978-3296
(219) 866-5141
(219) 866-2014
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200357640A
—
IN
Enumeration date
10/19/2009
Last updated
04/14/2010
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