Healthcare Provider Details
I. General information
NPI: 1619164001
Provider Name (Legal Business Name): ADAMS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/28/2007
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 IOWA AVE
CONNERSVILLE IN
47331-2404
US
IV. Provider business mailing address
1100 MERCER AVE PO BOX 151
DECATUR IN
46733-2303
US
V. Phone/Fax
- Phone: 765-825-7514
- Fax: 765-827-0116
- Phone: 260-724-2145
- Fax: 260-728-3852
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 070003182 |
| License Number State | IN |
VIII. Authorized Official
Name:
KYLE
R
SPRUNGER
Title or Position: ASSISTANT CFO
Credential: CPA
Phone: 260-724-2145