Healthcare Provider Details

I. General information

NPI: 1902315914
Provider Name (Legal Business Name): ADAMS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2017
Last Update Date: 09/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGH ST
GENEVA IN
46740-1020
US

IV. Provider business mailing address

1100 MERCER AVE
DECATUR IN
46733-2303
US

V. Phone/Fax

Practice location:
  • Phone: 260-368-7370
  • Fax: 260-726-7430
Mailing address:
  • Phone: 260-724-2145
  • Fax: 260-728-3852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANE WHEELER
Title or Position: CFO/TREASURER
Credential:
Phone: 260-724-2145