Healthcare Provider Details

I. General information

NPI: 1457516643
Provider Name (Legal Business Name): FLOYD MEMORIAL HOSPITAL AND HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 06/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9423 HIGHWAY 403
CHARLESTOWN IN
47111-9664
US

IV. Provider business mailing address

PO BOX 890728
CHARLOTTE NC
28289-0728
US

V. Phone/Fax

Practice location:
  • Phone: 812-256-6388
  • Fax: 812-256-0475
Mailing address:
  • Phone: 812-256-6388
  • Fax: 812-256-0475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWARD W. MILLER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 812-949-5500