MEDICARE: DAVIESS COUNTY HOSPITAL

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	12-000388-1	IN
2	313M00000X	Nursing Facility/Intermediate Care Facility	06-000388-1	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	:	1265515266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVIESS COUNTY HOSPITAL

Provider Business Mailing Address
First Line	:	1314 EAST WALNUT STREET, P.O. BOX 760
Second Line	:
City	:	WASHINGTON
State	:	IN
Zip	:	47501-0760
Country	:	US
Telephone Number	:	812-254-2760
Fax Number	:	260-728-3852

Provider Business Practice Location Address
First Line	:	1747 N RURAL ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-4425
Country	:	US
Telephone Number	:	317-635-1355
Fax Number	:

Authorized Official
Title or Position	:	BOARD CHAIR
Name	:	DERON STEINER
Credential	:
Telephone Number	:	812-254-2760

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	01/02/2021

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Directions to “DAVIESS COUNTY HOSPITAL ” Practice Location

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