Healthcare Provider Details

I. General information

NPI: 1235177981
Provider Name (Legal Business Name): DAVIESS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7519 WINCHESTER RD
FORT WAYNE IN
46819-2242
US

IV. Provider business mailing address

7519 WINCHESTER RD
FORT WAYNE IN
46819-2242
US

V. Phone/Fax

Practice location:
  • Phone: 260-747-7435
  • Fax: 260-747-9282
Mailing address:
  • Phone: 260-747-7435
  • Fax: 260-747-9282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number15-000250-1
License Number StateIN

VIII. Authorized Official

Name: MR. DERON STEINER
Title or Position: BOARD MEMBER
Credential:
Phone: 812-254-2760