Provider Demographics
NPI:1750333688
Name:BLUFFTON HEALTH SYSTEM LLC
Entity Type:Organization
Organization Name:BLUFFTON HEALTH SYSTEM LLC
Other - Org Name:BLUFFTON REGIONAL MEDICAL CENTER - HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, BUSINESS OFFICE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:1100 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-3615
Mailing Address - Country:US
Mailing Address - Phone:260-824-3500
Mailing Address - Fax:260-824-3704
Practice Address - Street 1:1100 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-3615
Practice Address - Country:US
Practice Address - Phone:260-824-3500
Practice Address - Fax:260-824-3704
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLUFFTON HEALTH SYSTEM LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-17
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
157166Medicare PIN