| Organization Name: | COMMUNITY HOPSITAL OF LAGRANGE COUNTY,INC |
| NPI Number: | 1316188667 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK NAFZIGER (EXECUTIVE VP--CFO) |
| Mailing Address: | 8175 West Us 20 Shipshewana |
| State: | IN US |
| Postal Code: | 465659169 |
| Phone Number: | 2607687432 |
| Fax Number: | 2607687482 |
| NPI Enumeration Date: | 03/17/2009 |
| NPI Last Update Date: | 03/17/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 01061887A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |