Healthcare Provider Details

I. General information

NPI: 1336186816
Provider Name (Legal Business Name): HENDRICKS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 HORNADAY RD
BROWNSBURG IN
46112-1972
US

IV. Provider business mailing address

1010 HORNADAY RD
BROWNSBURG IN
46112-1972
US

V. Phone/Fax

Practice location:
  • Phone: 317-852-3123
  • Fax:
Mailing address:
  • Phone: 317-852-3123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0011356384100
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number0011356384100
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number0011356384100
License Number StateIN

VIII. Authorized Official

Name: MR. KEVIN P. SPEER
Title or Position: CEO
Credential:
Phone: 317-745-4451