Healthcare Provider Details

I. General information

NPI: 1124894241
Provider Name (Legal Business Name): HANCOCK REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6189 W JOHN L MODGLIN DR STE 202
GREENFIELD IN
46140-9363
US

IV. Provider business mailing address

6189 W JOHN L MODGLIN DR STE 202
GREENFIELD IN
46140-9363
US

V. Phone/Fax

Practice location:
  • Phone: 317-477-9355
  • Fax:
Mailing address:
  • Phone: 317-477-9355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LINDA LANE
Title or Position: DIRECTOR
Credential:
Phone: 317-468-4479