Healthcare Provider Details

I. General information

NPI: 1275001489
Provider Name (Legal Business Name): DECATUR COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 11/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 N MICHIGAN AVE STE 2
GREENSBURG IN
47240-1487
US

IV. Provider business mailing address

720 N LINCOLN ST
GREENSBURG IN
47240-1327
US

V. Phone/Fax

Practice location:
  • Phone: 812-222-3627
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: REX MCKINNEY
Title or Position: PRESIDENT CEO
Credential:
Phone: 812-663-1171