Provider Demographics
NPI:1639241227
Name:WOODLAWN HOSPITAL
Entity Type:Organization
Organization Name:WOODLAWN HOSPITAL
Other - Org Name:ARGOS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-223-3141
Mailing Address - Street 1:530 N MICHIGAN
Mailing Address - Street 2:
Mailing Address - City:ARGOS
Mailing Address - State:IN
Mailing Address - Zip Code:46501
Mailing Address - Country:US
Mailing Address - Phone:574-892-5131
Mailing Address - Fax:574-892-6349
Practice Address - Street 1:530 N MICHIGAN
Practice Address - Street 2:
Practice Address - City:ARGOS
Practice Address - State:IN
Practice Address - Zip Code:46501
Practice Address - Country:US
Practice Address - Phone:574-892-5131
Practice Address - Fax:574-892-6349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051336A207Q00000X
IN01031969A207Q00000X
IN01038921A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E73944Medicare UPIN
H31557Medicare UPIN
194980BMedicare ID - Type Unspecified
194980AMedicare ID - Type Unspecified
D94887Medicare UPIN
194980CMedicare ID - Type Unspecified