NPIMap

Organization Active NPI

Witham Memorial Hospital

Doing business as Boone County EMS

  • Ambulance
  • Lebanon, IN
National Provider Identifier
1528100609
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
WITHAM MEMORIAL HOSPITAL
Doing business as
Boone County EMS
Practice address
2605 N Lebanon St
Lebanon, IN 46052-1476
Phone
(765) 485-8000
Fax
(765) 485-8069
NPI assigned
Feb 13, 2007
Last updated
Aug 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Authorized official

Name
Mr. George Pogas
Title
Cfo, Sr. Vice President
Phone
(765) 485-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X NU Primary

Addresses

Primary practice location

2605 N Lebanon St
Lebanon, IN 46052-1476

Mailing address

2605 N Lebanon St
Administration
Lebanon, IN 46052-1476
Phone (765) 485-8100

Other identifiers 1

IdentifierTypeStateIssuer
300079439MedicaidIN

Other names 1

  • Boone County EMS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
James Anthony Boudreau37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Locations

2605 N Lebanon St
Lebanon, IN 46052
Phone (765) 485-8000

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1528100609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "address_2": "ADMINISTRATION",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476",
            "telephone_number": "765-485-8100",
            "fax_number": "765-485-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476",
            "telephone_number": "765-485-8000",
            "fax_number": "765-485-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITHAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "POGAS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CFO, SR. VICE PRESIDENT",
        "authorized_official_telephone_number": "765-485-8100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300079439",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boone County EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boone County EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.