Basic Information
| Provider Information | |||||||||
| NPI: | 1205140993 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WABASH COUNTY HOSPITAL, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | WABASH PROFESSIONAL EMERGENCY PHYSICIANS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 710 N EAST ST | ||||||||
| Address2: | |||||||||
| City: | WABASH | ||||||||
| State: | IN | ||||||||
| PostalCode: | 469921914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2605633131 | ||||||||
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| Practice Location | |||||||||
| Address1: | 710 N EAST ST | ||||||||
| Address2: | |||||||||
| City: | WABASH | ||||||||
| State: | IN | ||||||||
| PostalCode: | 469921914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2605633131 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2010 | ||||||||
| LastUpdateDate: | 10/14/2011 | ||||||||
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| AuthorizedOfficialLastName: | BISSEL | ||||||||
| AuthorizedOfficialFirstName: | JANE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 2605692247 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.