MEDICARE: THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	13-000106-1	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144220823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY

Provider Business Mailing Address
First Line	:	776 N UNION ST
Second Line	:
City	:	WESTFIELD
State	:	IN
Zip	:	46074-9421
Country	:	US
Telephone Number	:	317-896-2515
Fax Number	:	317-867-0961

Provider Business Practice Location Address
First Line	:	776 N UNION ST
Second Line	:
City	:	WESTFIELD
State	:	IN
Zip	:	46074
Country	:	US
Telephone Number	:	317-896-2515
Fax Number	:	317-867-0961

Authorized Official
Title or Position	:	CFO OF ASC
Name	:	STEVE VAN CAMP
Credential	:	CPA
Telephone Number	:	317-788-2500

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	09/25/2020

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