Healthcare Provider Details

I. General information

NPI: 1386822914
Provider Name (Legal Business Name): HENDRICKS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2008
Last Update Date: 06/14/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 ANDREW AVE
LA PORTE IN
46350-6337
US

IV. Provider business mailing address

1900 ANDREW AVE
LA PORTE IN
46350-6337
US

V. Phone/Fax

Practice location:
  • Phone: 219-362-6234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateIN

VIII. Authorized Official

Name: KEVIN P SPEER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 317-745-4451