Healthcare Provider Details

I. General information

NPI: 1235315425
Provider Name (Legal Business Name): ADAMS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 ASH STREET
HUNTINGTON IN
46750-4101
US

IV. Provider business mailing address

1100 MERCER AVENUE
DECATUR IN
46733-2303
US

V. Phone/Fax

Practice location:
  • Phone: 260-358-0047
  • Fax: 260-356-5742
Mailing address:
  • Phone: 260-724-2145
  • Fax: 317-818-1022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number11-000569-1
License Number StateIN

VIII. Authorized Official

Name: MR. KYLE SPRUNGER
Title or Position: ASSISTANT CFO
Credential: CPA
Phone: 260-724-2145