Healthcare Provider Details

I. General information

NPI: 1467650655
Provider Name (Legal Business Name): MARGARET MARY COMMUNITY HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11137 US HIGHWAY 52 STE B
BROOKVILLE IN
47012-7901
US

IV. Provider business mailing address

PO BOX 236
BATESVILLE IN
47006-0236
US

V. Phone/Fax

Practice location:
  • Phone: 765-647-3547
  • Fax: 765-647-2170
Mailing address:
  • Phone: 812-933-5441
  • Fax: 812-933-5446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number01035790
License Number StateIN

VIII. Authorized Official

Name: BRIAN R DAEGER
Title or Position: CFO
Credential:
Phone: 812-933-5135