Healthcare Provider Details

I. General information

NPI: 1073554200
Provider Name (Legal Business Name): ADAMS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 SOUTH ANTHONY BOULEVARD
FORT WAYNE IN
46816-2035
US

IV. Provider business mailing address

1100 MERCER AVE
DECATUR IN
46733-2303
US

V. Phone/Fax

Practice location:
  • Phone: 260-447-0800
  • Fax: 260-447-7369
Mailing address:
  • Phone: 260-724-2145
  • Fax: 260-728-3852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number050002831
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number050002831
License Number StateIN

VIII. Authorized Official

Name: KYLE SPRUNGER
Title or Position: CFO/TREASURER
Credential:
Phone: 260-724-2145