Healthcare Provider Details

I. General information

NPI: 1285243618
Provider Name (Legal Business Name): HENDRICKS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8244 E US HIGHWAY 36 STE 1340
AVON IN
46123-9688
US

IV. Provider business mailing address

8244 E US HIGHWAY 36 STE 1340
AVON IN
46123-9688
US

V. Phone/Fax

Practice location:
  • Phone: 317-272-8272
  • Fax: 317-272-7507
Mailing address:
  • Phone: 317-272-8272
  • Fax: 317-272-7507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: HEATHER RUTHERFORD
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 317-837-5566