Healthcare Provider Details

I. General information

NPI: 1710093091
Provider Name (Legal Business Name): HARRISON COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

368 W OLD STATE ROAD 62
LEAVENWORTH IN
47137-2290
US

IV. Provider business mailing address

PO BOX 38
CORYDON IN
47112-0038
US

V. Phone/Fax

Practice location:
  • Phone: 812-739-4555
  • Fax: 812-739-4122
Mailing address:
  • Phone: 812-738-4251
  • Fax: 812-738-7833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES WILEY
Title or Position: CFO
Credential:
Phone: 812-738-4251