Healthcare Provider Details

I. General information

NPI: 1629337589
Provider Name (Legal Business Name): DAVIESS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 01/02/2021
Certification Date: 01/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 GRAND AVE
WASHINGTON IN
47501-2122
US

IV. Provider business mailing address

1402 GRAND AVE
WASHINGTON IN
47501-2122
US

V. Phone/Fax

Practice location:
  • Phone: 812-254-7310
  • Fax: 812-257-8602
Mailing address:
  • Phone: 812-254-7310
  • Fax: 812-257-8602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number01053199A
License Number StateIN

VIII. Authorized Official

Name: MR. JOHN ROSSFELD
Title or Position: CEO
Credential:
Phone: 812-254-2760