Organization Name:  JOHNSON MEMORIAL HOSPITAL


Practice Location:
1367 S RANDOLPH ST  GARRETT, IN 46738 US
Tel: 260-357-5174  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	332BN1400X	Suppliers Durable Medical Equipment & Medical Supplies Nursing Facility Supplies
N	332BP3500X	Suppliers Durable Medical Equipment & Medical Supplies	IN
Y	314000000X	Nursing & Custodial Care Facilities Skilled Nursing Facility	IN	06-000499-1

Other Provider Identifiers:

Issuer	Number	State	Type
	100266120A	IN	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin