Healthcare Provider Details

I. General information

NPI: 1609977628
Provider Name (Legal Business Name): ADAMS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 COLLEGE AVENUE
GOSHEN IN
46528
US

IV. Provider business mailing address

PO BOX 151 1100 MERCER AVENUE
DECATUR IN
46733-2303
US

V. Phone/Fax

Practice location:
  • Phone: 574-533-0351
  • Fax: 574-533-5714
Mailing address:
  • Phone: 260-724-2145
  • Fax: 260-728-3582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number000091
License Number StateIN

VIII. Authorized Official

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