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IN00159509 Unsubstantiated Facility Number 005053 Date 1/12/15 and 1/13/15 Surveyor Linda Plummer R.N. Public Health Nurse Surveyor QA claughlin 02/26/15 S 912 410 IAC 15-1. PRINTED 06/08/2015 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION X1 PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER MEMORIAL HOSPITAL OF SOUTH BEND X4 ID PREFIX TAG A. BUILDING X3 DATE SURVEY COMPLETED B. WING 005053 NAME OF PROVIDER OR SUPPLIER X2 MULTIPLE CONSTRUCTION...
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The Memorial Hospital of South is a healthcare facility located in the southern region.
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