Healthcare Provider Details

I. General information

NPI: 1902878994
Provider Name (Legal Business Name): COMMUNITY HOWARD REGIONAL HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 02/23/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 S LAFOUNTAIN ST
KOKOMO IN
46902-3803
US

IV. Provider business mailing address

3500 S LAFOUNTAIN ST
KOKOMO IN
46902-3803
US

V. Phone/Fax

Practice location:
  • Phone: 765-453-0702
  • Fax: 765-453-8087
Mailing address:
  • Phone: 765-453-0702
  • Fax: 765-453-8087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number060050071
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateIN

VIII. Authorized Official

Name: ELIZABETH SHIRENE THARP
Title or Position: CEO
Credential:
Phone: 765-298-5125