Healthcare Provider Details

I. General information

NPI: 1013133776
Provider Name (Legal Business Name): DAVIESS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 01/02/2021
Certification Date: 01/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2926 N. CAPITOL AVE
INDIANAPOLIS IN
46208-0356
US

IV. Provider business mailing address

1314 WALNUT STREET
WASHINGTON IN
47501-2860
US

V. Phone/Fax

Practice location:
  • Phone: 317-926-0254
  • Fax: 317-926-3130
Mailing address:
  • Phone: 812-254-2760
  • Fax: 260-728-3852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number07-000567-1
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number14-000567-2
License Number StateIN

VIII. Authorized Official

Name: DERON STEINER
Title or Position: BOARD CHAIR
Credential:
Phone: 812-254-2760