Healthcare Provider Details
I. General information
NPI: 1891896247
Provider Name (Legal Business Name): HENDRICKS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/26/2006
Last Update Date: 06/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 HOSPITAL LN SUITE 205
DANVILLE IN
46122-1989
US
IV. Provider business mailing address
1100 SOUTHFIELD DR SUITE 1370
PLAINFIELD IN
46168-4498
US
V. Phone/Fax
- Phone: 317-745-7128
- Fax: 317-745-3085
- Phone: 317-837-5571
- Fax: 317-837-5580
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0205X |
| Taxonomy | Pediatric Endocrinology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GENI
S
KLAYER
Title or Position: PHYSICIAN NETWORK DIRECTOR
Credential: RN,BSN,MBA
Phone: 317-837-5571