Healthcare Provider Details

I. General information

NPI: 1134489339
Provider Name (Legal Business Name): HENRY COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 CHATEAU DR
MUNCIE IN
47303-1900
US

IV. Provider business mailing address

1000 N 16TH ST
NEW CASTLE IN
47362-4319
US

V. Phone/Fax

Practice location:
  • Phone: 765-747-9044
  • Fax:
Mailing address:
  • Phone: 765-521-0890
  • 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: BRIAN RING
Title or Position: PRESIDENT/CEO
Credential:
Phone: 765-521-1515