Provider Demographics
NPI:1730494840
Name:WABASH COUNTY HOSPITAL, INC.
Entity Type:Organization
Organization Name:WABASH COUNTY HOSPITAL, INC.
Other - Org Name:FAMILY PHYSICIANS ASSOCIATED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BISSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-569-2247
Mailing Address - Street 1:1025 MANCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992-1425
Mailing Address - Country:US
Mailing Address - Phone:260-563-7421
Mailing Address - Fax:260-563-7725
Practice Address - Street 1:1025 MANCHESTER AVE
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992-1425
Practice Address - Country:US
Practice Address - Phone:260-563-7421
Practice Address - Fax:260-563-7725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100270190Medicaid
IN941160Medicare Oscar/Certification