Healthcare Provider Details

I. General information

NPI: 1720312705
Provider Name (Legal Business Name): HOWARD REGIONAL SPECIALTY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 09/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

829 N DIXON RD
KOKOMO IN
46901-1759
US

IV. Provider business mailing address

829 N DIXON RD
KOKOMO IN
46901-1759
US

V. Phone/Fax

Practice location:
  • Phone: 765-454-4531
  • Fax: 765-236-4011
Mailing address:
  • Phone: 765-454-4531
  • Fax: 765-236-4011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number09-003868-1
License Number StateIN

VIII. Authorized Official

Name: MRS. KIMBERLY ANN BROWN
Title or Position: LEAD PATIENT ACCOUNT REP
Credential:
Phone: 765-454-4531