Basic Information
| Provider Information | |||||||||
| NPI: | 1326531179 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CAMERON MEMORIAL COMMUNITY HOSPITAL INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | URGENT CARE OF CAMERON HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 416 E MAUMEE ST | ||||||||
| Address2: | |||||||||
| City: | ANGOLA | ||||||||
| State: | IN | ||||||||
| PostalCode: | 467032015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2606675133 | ||||||||
| FaxNumber: | 2606657893 | ||||||||
| Practice Location | |||||||||
| Address1: | 1381 N WAYNE ST | ||||||||
| Address2: | |||||||||
| City: | ANGOLA | ||||||||
| State: | IN | ||||||||
| PostalCode: | 467032348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2606658222 | ||||||||
| FaxNumber: | 2606658970 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2018 | ||||||||
| LastUpdateDate: | 05/19/2021 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | ALCAZAR | ||||||||
| AuthorizedOfficialFirstName: | CARLOS | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VP/CFO | ||||||||
| AuthorizedOfficialTelephone: | 2606675133 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.