Healthcare Provider Details

I. General information

NPI: 1215497763
Provider Name (Legal Business Name): HENDRICKS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8244 E US HIGHWAY 36 STE 150
AVON IN
46123-5526
US

IV. Provider business mailing address

1100 SOUTHFIELD DR STE 1370
PLAINFIELD IN
46168-4300
US

V. Phone/Fax

Practice location:
  • Phone: 317-745-3525
  • Fax: 317-718-4072
Mailing address:
  • Phone: 317-837-5570
  • Fax: 317-837-5580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: GENI KLAYER
Title or Position: NETWORK DIRECTOR
Credential: RN,BSN,MBA,MJ
Phone: 317-837-5571