Healthcare Provider Details

I. General information

NPI: 1942220785
Provider Name (Legal Business Name): BOARD OF TRUSTEES OF HOWARD COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3506 S LAFOUNTAIN ST
KOKOMO IN
46902-3803
US

IV. Provider business mailing address

PO BOX 2943
INDIANAPOLIS IN
46206-2943
US

V. Phone/Fax

Practice location:
  • Phone: 765-864-6700
  • Fax: 765-864-6703
Mailing address:
  • Phone: 765-864-6700
  • Fax: 765-864-6703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS M COOK
Title or Position: CFO
Credential:
Phone: 765-453-7189