Healthcare Provider Details

I. General information

NPI: 1669883252
Provider Name (Legal Business Name): HANCOCK REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5404 GEORGETOWN RD
INDIANAPOLIS IN
46254-5500
US

IV. Provider business mailing address

5404 GEORGETOWN RD
INDIANAPOLIS IN
46254-5500
US

V. Phone/Fax

Practice location:
  • Phone: 317-291-5404
  • Fax: 317-291-1180
Mailing address:
  • Phone: 317-291-5404
  • Fax: 317-291-1180

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 V. LONG
Title or Position: PRESIDENT/CEO
Credential:
Phone: 317-468-4412