Healthcare Provider Details

I. General information

NPI: 1144253451
Provider Name (Legal Business Name): ADAMS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4851 TINCHER RD
INDIANAPOLIS IN
46221-3780
US

IV. Provider business mailing address

1100 MERCER AVE
DECATUR IN
46733-2303
US

V. Phone/Fax

Practice location:
  • Phone: 317-856-4851
  • Fax: 317-856-4852
Mailing address:
  • Phone: 260-724-2145
  • Fax: 260-728-3852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number05-000229-1
License Number StateIN

VIII. Authorized Official

Name: DANE WHEELER
Title or Position: CFO
Credential: CPA
Phone: 260-724-2145