| Organization Name: | JOHNSON MEMORIAL HOSPITAL |
| NPI Number: | 1144236415 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LARRY HEYDON (CEO) |
| Mailing Address: | 1720 Alber St Wabash |
| State: | IN US |
| Postal Code: | 469921015 |
| Phone Number: | 2605634112 |
| Fax Number: | 2605635611 |
| NPI Enumeration Date: | 07/31/2006 |
| NPI Last Update Date: | 04/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BP3500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Parenteral & Enteral Nutrition |
| Taxonomy Definition: | |