Healthcare Provider Details

I. General information

NPI: 1811199037
Provider Name (Legal Business Name): BOARD OF TRUSTEES OF HOWARD COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3611 S REED RD SUITE 106
KOKOMO IN
46902-3828
US

IV. Provider business mailing address

PO BOX 1751
INDIANAPOLIS IN
46206-1751
US

V. Phone/Fax

Practice location:
  • Phone: 765-864-5725
  • Fax: 765-864-5726
Mailing address:
  • Phone: 765-864-5725
  • Fax: 765-864-5726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS M COOK
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 765-453-8179