Healthcare Provider Details

I. General information

NPI: 1275959751
Provider Name (Legal Business Name): JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2014
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 WOODIES LN
BREMEN IN
46506-1354
US

IV. Provider business mailing address

316 WOODIES LN
BREMEN IN
46506-1354
US

V. Phone/Fax

Practice location:
  • Phone: 574-546-3494
  • Fax: 574-546-3199
Mailing address:
  • Phone: 574-546-3494
  • Fax: 574-546-3199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: WARREN FORGEY
Title or Position: TREASURER
Credential:
Phone: 812-522-4238