Healthcare Provider Details

I. General information

NPI: 1063409456
Provider Name (Legal Business Name): THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 ALBANY ST
BEECH GROVE IN
46107
US

IV. Provider business mailing address

2002 ALBANY ST
BEECH GROVE IN
46107-1408
US

V. Phone/Fax

Practice location:
  • Phone: 317-783-2911
  • Fax: 317-781-3774
Mailing address:
  • Phone: 317-783-2911
  • Fax: 317-781-3774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number05-000029-1
License Number StateIN

VIII. Authorized Official

Name: STEVE VAN CAMP
Title or Position: CFO OF ASC
Credential: ASC
Phone: 317-788-2500