Healthcare Provider Details
I. General information
NPI: 1245918200
Provider Name (Legal Business Name): HENDRICKS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2023
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
602 N HIGH SCHOOL RD STE C
INDIANAPOLIS IN
46214-3695
US
IV. Provider business mailing address
1100 SOUTHFIELD DR STE 1370
PLAINFIELD IN
46168-4300
US
V. Phone/Fax
- Phone: 317-838-9355
- Fax: 317-718-2955
- Phone: 317-837-5566
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QC1800X |
| Taxonomy | Corporate Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HEATHER
RUTHERFORD
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 317-837-5566