Healthcare Provider Details

I. General information

NPI: 1730424474
Provider Name (Legal Business Name): DAVIESS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2012
Last Update Date: 01/02/2021
Certification Date: 01/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W ESSEX ST
LEBANON IN
46052-1755
US

IV. Provider business mailing address

1314 EAST WALNUT STREET, P.O. BOX 760
WASHINGTON IN
47501-0760
US

V. Phone/Fax

Practice location:
  • Phone: 765-482-1950
  • Fax: 765-482-1282
Mailing address:
  • Phone: 812-254-2760
  • Fax: 260-728-3852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number12-000291-2
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number12-000291-2
License Number StateIN

VIII. Authorized Official

Name: DERON STEINER
Title or Position: BOARD CHAIR
Credential:
Phone: 812-254-2760