Healthcare Provider Details

I. General information

NPI: 1639514375
Provider Name (Legal Business Name): JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 S SUGAR ST
BROWNSTOWN IN
47220-2066
US

IV. Provider business mailing address

621 S SUGAR ST
BROWNSTOWN IN
47220-2066
US

V. Phone/Fax

Practice location:
  • Phone: 812-358-2504
  • Fax: 812-358-2510
Mailing address:
  • Phone: 812-358-2504
  • Fax: 812-358-2510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

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