Healthcare Provider Details

I. General information

NPI: 1972863421
Provider Name (Legal Business Name): PUTNAM COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 05/03/2021
Certification Date: 05/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 NORTH TODD DRIVE
SCOTTSBURG IN
47170-7755
US

IV. Provider business mailing address

1350 NORTH TODD DRIVE
SCOTTSBURG IN
47170-7755
US

V. Phone/Fax

Practice location:
  • Phone: 812-752-5663
  • Fax:
Mailing address:
  • Phone: 812-752-5663
  • 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: DENNIS WEATHERFORD
Title or Position: CEO
Credential:
Phone: 765-301-7525