Healthcare Provider Details

I. General information

NPI: 1801137948
Provider Name (Legal Business Name): JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2013
Last Update Date: 01/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 N WALNUT ST
MUNCIE IN
47303-1190
US

IV. Provider business mailing address

4301 N WALNUT ST
MUNCIE IN
47303-1190
US

V. Phone/Fax

Practice location:
  • Phone: 765-282-0053
  • Fax: 765-282-3290
Mailing address:
  • Phone: 765-282-0053
  • Fax: 765-282-3290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: WARREN FORGEY
Title or Position: TREASURER
Credential:
Phone: 812-522-0172