Provider Demographics
NPI:1679173306
Name:WARSAW HEALTH SYSTEM LLC
Entity Type:Organization
Organization Name:WARSAW HEALTH SYSTEM LLC
Other - Org Name:KOSCIUSKO COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:LALOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-215-3953
Mailing Address - Street 1:2101 DUBOIS DR
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-3210
Mailing Address - Country:US
Mailing Address - Phone:574-267-3200
Mailing Address - Fax:574-372-7692
Practice Address - Street 1:2101 DUBOIS DR
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-3210
Practice Address - Country:US
Practice Address - Phone:574-267-3200
Practice Address - Fax:574-372-7692
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WARSAW HEALTH SYSTEM LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-30
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit