Healthcare Provider Details

I. General information

NPI: 1528143963
Provider Name (Legal Business Name): BOARD OF TRUSTEES OF HOWARD COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 S REED RD
KOKOMO IN
46902-3838
US

IV. Provider business mailing address

3505 S REED RD
KOKOMO IN
46902-3838
US

V. Phone/Fax

Practice location:
  • Phone: 765-453-8668
  • Fax: 765-453-8506
Mailing address:
  • Phone: 765-453-8668
  • Fax: 765-453-8506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number01052732
License Number StateIN

VIII. Authorized Official

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