Healthcare Provider Details

I. General information

NPI: 1669466546
Provider Name (Legal Business Name): DAVIESS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 01/02/2021
Certification Date: 01/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8935 E 46TH ST
INDIANAPOLIS IN
46226-4125
US

IV. Provider business mailing address

1314 WALNUT STREET
WASHINGTON IN
47501-2860
US

V. Phone/Fax

Practice location:
  • Phone: 317-898-1515
  • Fax:
Mailing address:
  • Phone: 812-254-2760
  • Fax: 260-728-3582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number040003831
License Number StateIN

VIII. Authorized Official

Name: DERON STEINER
Title or Position: BOARD CHAIR
Credential:
Phone: 812-254-2760