Healthcare Provider Details

I. General information

NPI: 1922098607
Provider Name (Legal Business Name): GREENE COUNTY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 NEWTON ST
JASPER IN
47547-1047
US

IV. Provider business mailing address

1185 N 1000 W
LINTON IN
47441-5282
US

V. Phone/Fax

Practice location:
  • Phone: 812-482-1722
  • Fax: 812-634-2793
Mailing address:
  • Phone: 812-847-2281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: BRENDA REETZ
Title or Position: CEO
Credential:
Phone: 812-847-5212