Healthcare Provider Details

I. General information

NPI: 1902920069
Provider Name (Legal Business Name): ADAMS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 11/22/2022
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 BIELBY ROAD
LAWRENCEBURG IN
47025-1003
US

IV. Provider business mailing address

1100 MERCER AVENUE
DECATUR IN
46733-2303
US

V. Phone/Fax

Practice location:
  • Phone: 812-537-1132
  • Fax: 812-537-4636
Mailing address:
  • Phone: 260-724-2145
  • Fax: 317-818-1022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number11-000022-1
License Number StateIN

VIII. Authorized Official

Name: MR. KYLE SPRUNGER
Title or Position: ASSISTANT CFO
Credential: CPA
Phone: 260-724-2145