Healthcare Provider Details

I. General information

NPI: 1730177551
Provider Name (Legal Business Name): ADAMS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 02/02/2024
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N BOEKE RD
EVANSVILLE IN
47711-5925
US

IV. Provider business mailing address

1100 MERCER AVENUE
DECATUR IN
46733-2303
US

V. Phone/Fax

Practice location:
  • Phone: 812-476-4912
  • Fax: 812-759-0514
Mailing address:
  • Phone: 260-724-2145
  • Fax: 260-728-3852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number13-000439-1
License Number StateIN

VIII. Authorized Official

Name: MR. KYLE SPRUNGER
Title or Position: ASSISTANT CFO
Credential: CPA
Phone: 260-724-2145