Healthcare Provider Details

I. General information

NPI: 1962129494
Provider Name (Legal Business Name): PUTNAM COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 11/28/2022
Certification Date: 11/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 MEDIC WAY
GREENCASTLE IN
46135-2296
US

IV. Provider business mailing address

1542 S BLOOMINGTON ST
GREENCASTLE IN
46135-2297
US

V. Phone/Fax

Practice location:
  • Phone: 765-653-4633
  • Fax:
Mailing address:
  • Phone: 765-301-7449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES ALAN NERONE
Title or Position: CFO
Credential:
Phone: 765-301-7532