Healthcare Provider Details
I. General information
NPI: 1114016987
Provider Name (Legal Business Name): HANCOCK REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/12/2006
Last Update Date: 08/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 MEMORIAL SQ STE 100
GREENFIELD IN
46140-2819
US
IV. Provider business mailing address
PO BOX 129
GREENFIELD IN
46140-0129
US
V. Phone/Fax
- Phone: 317-462-3255
- Fax:
- Phone: 317-468-6221
- Fax: 317-468-6267
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
RICK
EDWARDS
Title or Position: VP OF FINANCE & BUSINESS SERV
Credential:
Phone: 317-485-4577