Healthcare Provider Details
I. General information
NPI: 1346346269
Provider Name (Legal Business Name): HENDRICKS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/16/2006
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
112 HOSPITAL LN SUITE 110
DANVILLE IN
46122-2600
US
IV. Provider business mailing address
1100 SOUTHFIELD DR SUITE 1370
PLAINFIELD IN
46168-4498
US
V. Phone/Fax
- Phone: 317-745-8790
- Fax: 317-745-8793
- Phone: 317-837-5571
- Fax: 317-837-5580
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HEATHER
RUTHERFORD
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 317-837-5566