Healthcare Provider Details

I. General information

NPI: 1053465757
Provider Name (Legal Business Name): HEALTH & HOSPITAL CORPORATION OF MARION COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 INDIANA AVE
INDIANAPOLIS IN
46202-2915
US

IV. Provider business mailing address

980 INDIANA AVE
INDIANAPOLIS IN
46202-2915
US

V. Phone/Fax

Practice location:
  • Phone: 317-269-0448
  • Fax: 317-655-3880
Mailing address:
  • Phone: 317-269-0448
  • Fax: 317-655-3880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0600008-1
License Number StateIN

VIII. Authorized Official

Name: MR. MATTHEW R GUTWEIN
Title or Position: PRESIDENT AND EXECUTIVE DIRECTOR
Credential:
Phone: 317-221-2009