NPIMap

Organization Active NPI

Witham Memorial Hospital

  • Institutional Pharmacy
  • Lebanon, IN
National Provider Identifier
1801204201
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
60000062A Issued in IN
Legal business name
WITHAM MEMORIAL HOSPITAL
Practice address
2705 N Lebanon St
Lebanon, IN 46052-8621
Phone
(765) 485-8390
Fax
(765) 485-8399
NPI assigned
Jul 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Authorized official

Name
Aaron Lee
Title
Director of Pharmacy
Phone
(765) 485-8395

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 60000062A IN Primary

Addresses

Primary practice location

2705 N Lebanon St
Lebanon, IN 46052-8621

Mailing address

2705 N Lebanon St
Lebanon, IN 46052-8621
Phone (765) 485-8390

Other identifiers 2

IdentifierTypeStateIssuer
100269130AMedicaidIN
2147057OtherPK

Other names 1

  • Witham Health Services Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2048784Witham Health Services2705 N Lebanon St Ste 265, Lebanon, IN 46052Certificate of waiverOct 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
Hoosier Enterprises II Inc37 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

NPI Registry JSON

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1801204201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460528621",
            "telephone_number": "765-485-8390",
            "fax_number": "765-485-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460528621",
            "telephone_number": "765-485-8390",
            "fax_number": "765-485-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITHAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-29",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "765-485-8395"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "IN",
            "license": "60000062A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100269130A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147057",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Witham Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Witham Health Services",
            "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 Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.