Healthcare Provider Details

I. General information

NPI: 1952726663
Provider Name (Legal Business Name): HANCOCK REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2014
Last Update Date: 05/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18275 S BURR ST
LOWELL IN
46356-0020
US

IV. Provider business mailing address

PO BOX 221648
LOUISVILLE KY
40252-1648
US

V. Phone/Fax

Practice location:
  • Phone: 219-696-6750
  • Fax: 219-696-6810
Mailing address:
  • Phone: 502-412-5847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEVEN LONG
Title or Position: PRESIDENT & CEO
Credential:
Phone: 317-462-5544