Healthcare Provider Details
I. General information
NPI: 1831589498
Provider Name (Legal Business Name): HANCOCK REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/03/2015
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14751 CAREY RD
CARMEL IN
46033-9084
US
IV. Provider business mailing address
14751 CAREY RD
CARMEL IN
46033-9084
US
V. Phone/Fax
- Phone: 317-575-2208
- Fax: 317-575-6102
- Phone: 317-575-2208
- Fax: 317-575-6102
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 15-012548-1 |
| License Number State | IN |
VIII. Authorized Official
Name:
STEVEN
V
LONG
Title or Position: PRESIDENT/CEO
Credential:
Phone: 317-462-5544