Healthcare Provider Details

I. General information

NPI: 1477626026
Provider Name (Legal Business Name): ADAMS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 BEACHWAY DRIVE
INDIANAPOLIS IN
46224-8501
US

IV. Provider business mailing address

1100 MERCER AVENUE
DECATUR IN
46733-2303
US

V. Phone/Fax

Practice location:
  • Phone: 317-243-3721
  • Fax:
Mailing address:
  • Phone: 260-724-2145
  • Fax: 317-818-1022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number11-000032-1
License Number StateIN

VIII. Authorized Official

Name: MR. KYLE SPRUNGER
Title or Position: ASSISTANT CFO
Credential: CPA
Phone: 260-724-2145