NPIMap

Organization Active NPI

Goshen Hospital Association, Inc.

  • Home Infusion Therapy Pharmacy
  • Goshen, IN
National Provider Identifier
1114030939
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
Legal business name
GOSHEN HOSPITAL ASSOCIATION, INC.
Practice address
200 High Park Ave
Goshen, IN 46526-4810
Phone
(574) 535-2700
NPI assigned
Aug 16, 2006
Organization subpart
Yes
Parent organization
GOSHEN HOSPITAL ASSOCIATION, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James O Dague
Title
Chief Executive Officer
Phone
(574) 533-2141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Therapy Pharmacy 3336H0001X Primary

Addresses

Primary practice location

200 High Park Ave
Goshen, IN 46526-4810

Mailing address

1721 S Main St
Identifiers
Goshen, IN 46526-4723
Phone (574) 533-2141

Other identifiers 1

IdentifierTypeStateIssuer
000000098260OtherINBCBS

Other names 1

  • Care At Home Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Goshen General Hospital6 organizations share this tax ID, including this one
Part of
Goshen General Hospital

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1721 S Main St
Goshen, IN 46526
Phone (574) 364-2700

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196899200000",
    "number": "1114030939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 S MAIN ST",
            "address_2": "IDENTIFIERS",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264723",
            "telephone_number": "574-533-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGH PARK AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264810",
            "telephone_number": "574-535-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSHEN HOSPITAL ASSOCIATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOSHEN HOSPITAL ASSOCIATION, INC.",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-12-06",
        "status": "A",
        "authorized_official_last_name": "DAGUE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "574-533-2141"
    },
    "taxonomies": [
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000098260",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Care At Home Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goshen, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.