Healthcare Provider Details

I. General information

NPI: 1659300440
Provider Name (Legal Business Name): HENDRICKS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 S INDIANA ST
GREENCASTLE IN
46135-1926
US

IV. Provider business mailing address

6081 E. 82ND ST. SUITE 120
INDIANAPOLIS IN
46250-1562
US

V. Phone/Fax

Practice location:
  • Phone: 765-653-3143
  • Fax: 765-653-1651
Mailing address:
  • Phone: 317-570-0266
  • Fax: 317-570-0488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number05-000418-1
License Number StateIN

VIII. Authorized Official

Name: DEANNA FENOUGHTY
Title or Position: CEO
Credential: MD
Phone: 317-745-3775