Healthcare Provider Details

I. General information

NPI: 1619337839
Provider Name (Legal Business Name): HANCOCK REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4904 WAR ADMIRAL DR
INDIANAPOLIS IN
46237-9737
US

IV. Provider business mailing address

4904 WAR ADMIRAL DR
INDIANAPOLIS IN
46237-9737
US

V. Phone/Fax

Practice location:
  • Phone: 317-885-3333
  • Fax: 317-883-3221
Mailing address:
  • Phone: 317-885-3333
  • Fax: 317-883-3221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: STEVEN LONG
Title or Position: PRESIDENT/CEO
Credential:
Phone: 317-462-5544