Healthcare Provider Details

I. General information

NPI: 1417085770
Provider Name (Legal Business Name): INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 11/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S MAIN ST
TIPTON IN
46072-9753
US

IV. Provider business mailing address

1000 S MAIN ST
TIPTON IN
46072-9753
US

V. Phone/Fax

Practice location:
  • Phone: 765-675-8500
  • Fax: 765-675-8250
Mailing address:
  • Phone: 765-675-8500
  • Fax: 765-675-8520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL HARLOWE
Title or Position: PRESIDENT / CEO
Credential:
Phone: 765-675-8501