Healthcare Provider Details

I. General information

NPI: 1861536930
Provider Name (Legal Business Name): HENDRICKS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SOUTHFIELD DR STE. 1140
PLAINFIELD IN
46168-4498
US

IV. Provider business mailing address

1100 SOUTHFIELD DR STE. 1140
PLAINFIELD IN
46168-4498
US

V. Phone/Fax

Practice location:
  • Phone: 317-839-7200
  • Fax: 317-837-7926
Mailing address:
  • Phone: 317-839-7200
  • Fax: 317-837-7926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier100442010B
Identifier TypeMEDICAID
Identifier StateIN
Identifier Issuer

VIII. Authorized Official

Name: MARIJANE SMALLWOOD
Title or Position: DIRECTOR
Credential: RN, MSN, NE-BC
Phone: 317-272-7500