Healthcare Provider Details

I. General information

NPI: 1942373154
Provider Name (Legal Business Name): HENRY COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 08/17/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 WITTENBRAKER AVE STE 100
NEW CASTLE IN
47362-5035
US

IV. Provider business mailing address

PO BOX 485
NEW CASTLE IN
47362-0485
US

V. Phone/Fax

Practice location:
  • Phone: 765-521-0901
  • Fax: 765-521-9891
Mailing address:
  • Phone: 765-521-1516
  • Fax: 765-599-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number50003788A
License Number StateIN

VIII. Authorized Official

Name: MR. BRIAN RING
Title or Position: PRESIDENT & CEO
Credential:
Phone: 765-521-1515