Healthcare Provider Details

I. General information

NPI: 1114125689
Provider Name (Legal Business Name): ADAMS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 05/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E PRAIRIE ST
WARSAW IN
46580-4429
US

IV. Provider business mailing address

1100 MERCER AVE PO BOX 151
DECATUR IN
46733-2303
US

V. Phone/Fax

Practice location:
  • Phone: 574-267-8922
  • Fax: 574-258-2711
Mailing address:
  • Phone: 260-724-2145
  • Fax: 260-728-3852

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: MR. DANE WHEELER
Title or Position: CFO/TREASURER
Credential: CPA
Phone: 260-724-2145