Healthcare Provider Details
I. General information
NPI: 1417903980
Provider Name (Legal Business Name): HENDRICKS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2006
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2002 W 86TH ST
INDIANAPOLIS IN
46260-1903
US
IV. Provider business mailing address
2002 W 86TH ST
INDIANAPOLIS IN
46260-1903
US
V. Phone/Fax
- Phone: 317-872-8811
- Fax:
- Phone: 317-872-8811
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KEVIN
P
SPEER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 317-745-4451