Provider Demographics
NPI:1417440264
Name:CAMERON MEMORIAL COMMUNITY HOSPITAL INC
Entity Type:Organization
Organization Name:CAMERON MEMORIAL COMMUNITY HOSPITAL INC
Other - Org Name:CAMERON OB/GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-667-5133
Mailing Address - Street 1:416 E MAUMEE ST
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46703-2001
Mailing Address - Country:US
Mailing Address - Phone:260-667-5133
Mailing Address - Fax:260-665-7893
Practice Address - Street 1:306 E MAUMEE ST STE 101
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-2037
Practice Address - Country:US
Practice Address - Phone:260-667-5670
Practice Address - Fax:260-667-5680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health